Which transplant technique will let cystic fibrosis patients breathe easier?
Article Abstract:
People with cystic fibrosis (an inherited disease associated with gastrointestinal malfunction and chronic respiratory infection and failure) are candidates for new lungs. The status of heart-lung transplantation in these patients was reviewed at a recent meeting of the American Association for Thoracic Surgery. The Lung Transplant Research Unit at Papworth Hospital in England conducts a heart-lung transplantation program of international renown. During the past four years, 32 patients with cystic fibrosis (average age, 20) underwent heart-lung transplantation. Ten died within one year due to early graft failure, aspiration pneumonia (pneumonia after foreign matter is inhaled), obliterative bronchiolitis, and other causes. Obliterative bronchiolitis (inflammation with obstruction of the smaller airways in the lung) is a major complication. The survivors currently have an unrestricted lifestyle, with no recurrence of cystic fibrosis. However, symptoms in other organs have not been cured, and must be treated. Cystic fibrosis patients are monitored intensively for signs of rejection after transplantation. Survival to one year after transplantation was slightly higher for a group of patients without cystic fibrosis (75 percent) than for the group with cystic fibrosis (67 percent); but after one year, survival was about the same (58 percent) for both groups. Matching donor and recipient for cytomegalovirus (CMV) is also important in reducing mortality. Before a CMV-matching program began, six of eight transplant patients who were mismatched developed CMV disease. After matching was included in the program, only one of 48 recipients developed the disease due to mismatch. Careful screening of recipients is essential for such a program to work. Results of double-lung transplants were also reported at the meeting. Most investigators believed this approach is promising, but that further data are required, especially regarding obliterative bronchiolitis. In the US, both kinds of transplantation are performed for cystic fibrosis, but a strong case is made for the double-lung approach. This leaves donor hearts for transplantation in people with heart disease, and seems to allow patients a quicker recovery and a better quality of life. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
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Mother to child: first living donor lung transplant
Article Abstract:
In order to save her 12-year-old daughter's life, Versell Johnson, 45, underwent removal of one-third of her right lung for transplantation into her daughter. The child has bronchopulmonary dysplasia (inadequate development of the lung), a complication of ventilator-assisted respiration after her premature birth. The new organ will completely replace her right lung. Vaughn A. Starnes of Stanford University Medical Center performed the operation, the first lung transplant in which a lung from a living donor was used. He believes that children suffering from a variety of conditions could benefit from lung transplants, whether from live-donor or cadaveric tissue. A complication of lung transplantation from unrelated donors in children is a high rejection rate; using the mother's lung reduced this risk. Without the procedure, the child was unlikely to live more than another year and a half. Now, mother and child are expected to resume normal lives. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
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Lung transplantation
Article Abstract:
Single-lung transplantation (SLT) may be an effective and safe treatment for different types of lung disease. These diseases include chronic obstructive lung disease, restrictive lung disease and primary pulmonary hypertension. Patients with cystic fibrosis may undergo sequential transplantation of both lungs, and patients with both heart and lung disease may benefit from a heart-lung transplant. Individuals who undergo a lung transplant must be suffering from end-stage lung disease or heart-lung disease, but they should not have any other serious illnesses. The side on which to perform a SLT depends on the type of lung disease. Patients who undergo lung transplantation risk developing various types of infections during the first six months following the procedure, and infection is the most common cause of death in this period. Another risk is chronic rejection of the transplanted organ.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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