Heart and lung transplantation

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

Abstract

Heart and lung transplantation is a story of bold experiments leading to early clinical application with poor results but ultimately the emergence of a highly effective therapy for end stage heart and lung disease. For successful heart and lung transplantation to work, there needs to be a convergence of many components. The initial step is appropriate recipient selection, a process which determines that transplantation is indicated, excludes contraindications and ensures that there are no effective alternate therapies. Following listing for transplantation a donor search is commenced and a key ingredient is prudent donor selection recognizing that brain death is a toxic physiological environment that is particularly damaging to the myocardium of a donor heart. The surgical implantation of donor heart, lungs or heart/lungs are now standard procedures. Immunosuppression although now more targeted than in the early days of transplantation is still associated with substantial complications that require ongoing surveillance. Survival after heart and lung transplantation has improved primarily due to the decreased incidence and impact of early causes of death such as acute rejection and primary graft dysfunction but the impact of late causes of death due to chronic rejection (chronic lung allograft dysfunction in the transplanted lung and cardiac allograft vasculopathy in the transplanted heart) have not appreciably reduced.

Original languageEnglish
Title of host publicationMechanical Circulatory and Respiratory Support
PublisherElsevier
Pages37-89
Number of pages53
ISBN (Electronic)9780128104927
ISBN (Print)9780128104910
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Complications of transplantation
  • Donor physiology
  • Heart transplantation
  • History of heart and lung transplantation
  • Immunosuppression
  • Lung transplantation
  • Surgical techniques of cardiothoracic transplantation
  • Survival after heart and lung transplantation

Cite this

McGiffin, D. C., & Marasco, S. F. (2018). Heart and lung transplantation. In Mechanical Circulatory and Respiratory Support (pp. 37-89). Elsevier. https://doi.org/10.1016/B978-0-12-810491-0.00002-3