Combined heart-lung transplantation for end-stage XXXX .

@entity1 @entity1353 @entity358 @entity1576 @entity4154 @entity6924 @entity4288
Between May, 1981, and December, 1984, thirteen combined heart-lung transplants were performed in 12 @entity1 for the treatment of @entity6924 . The age range of the recipients was 22 to 42 years. Two @entity1 had undergone previous open cardiac operations; in addition, one had had closure of a persistent ductus arteriosus, one an open lung biopsy, one a pulmonary artery banding, and one @entity1 received a second heart-lung transplant after 3 years. Four recipients died before hospital discharge, one at operation and three at 4, 10, and 33 days after operation. Early symptomatic results and cardiopulmonary function were excellent in all of the survivors. Two @entity1 died 14 and 15 months after transplantation of accelerated graft @entity4288 and @entity1576 , respectively, and six remain alive 7 to 44 months after transplantation. Four of these surviving @entity1 and the two @entity1 who died late subsequently had major @entity358 . Symptoms included progressive @entity1353 , cough (often productive), and fever with physical signs of diffuse crepitations and expiratory rhonchi. Serial pulmonary function tests showed progressive obstructive physiology in all six @entity1 with superimposed restrictive defects in four. Histologic examination of tissue from open lung biopsy or autopsy displayed @entity4154 in five of these @entity1 , one of whom required retransplantation. It is possible that these late changes are the result of rejection, since similar changes in one other @entity1 have now been reversed with augmented immunosuppression. Further understanding of the causes and manifestations of late @entity358 should improve the late functional results of this operation for @entity6924 .
