Letsou G V, Franco K L, Kopf G S, Dewar M L, Elefteriades J A, Hammond G L, Baldwin J C
Yale University School of Medicine.
Conn Med. 1990 Aug;54(8):419-24.
Between May 1988 and June 1989, five combined heart-lung transplants were performed. There were two males, age 16 and 19 years, and three females age 33, 34, and 19 years. Three patients had primary pulmonary hypertension, one had cystic fibrosis, and the fifth had doxorubicin-induced cardiomyopathy with associated pulmonary hypertension. All patients were severely restricted in functional capacity and were oxygen-dependent. Four grafts were distantly procured (ischemic times 1:15, 2:35, 2:45, 3:45); one was procured on-site (ischemic time 0:58). Four of five grafts functioned well (PO2 on FIO2 30% postoperatively: 102, 120, 180, and 129 torr). One graft (distantly procured with an ischemic time of 1:15) showed total failure of oxygenation secondary to fluid overload during donor surgery; the recipient could not be weaned from cardiopulmonary bypass. All patients were extubated 24 to 30 hours postoperatively. Rejection episodes have been infrequent and all have been successfully treated with pulse steroids. Four of the five patients are alive and well with normal cardiopulmonary function and normal functional capacity 15, 12, 8, and 6 months after surgery. Heart-lung transplantation is an effective therapy for properly selected patients with end-stage cardiopulmonary disease resulting from a variety of primary disorders.
1988年5月至1989年6月期间，共进行了5例心肺联合移植手术。其中男性2例，年龄分别为16岁和19岁；女性3例，年龄分别为33岁、34岁和19岁。3例患者患有原发性肺动脉高压，1例患有囊性纤维化，第5例患有阿霉素诱导的心肌病并伴有肺动脉高压。所有患者的功能能力均受到严重限制，且依赖氧气。4例移植物是远距离获取的（缺血时间分别为1小时15分、2小时35分、2小时45分、3小时45分）；1例是在本地获取的（缺血时间为0小时58分）。5例移植物中有4例功能良好（术后吸入氧浓度30%时的动脉血氧分压：102、120、180和129托）。1例移植物（远距离获取，缺血时间为1小时15分）在供体手术期间因液体超负荷导致氧合完全失败；受体无法脱离体外循环。所有患者术后24至30小时拔除气管插管。排斥反应不常见，所有病例均通过脉冲类固醇成功治疗。5例患者中有4例在术后15、12、8和6个月时存活，心肺功能正常，功能能力正常。心肺移植对于因各种原发性疾病导致的终末期心肺疾病的合适患者是一种有效的治疗方法。
