Lung and Heart-Lung Transplantation

  • Stephan L. Kamholz
  • Frank J. Veith


Each year thousands of patients die of incurable cardiopulmonary diseases. Despite major advances in medical and surgical therapy for some of these problems, severe chronic obstructive pulmonary disease, chronic idiopathic pulmonary fibrosis, advanced diseases of the pulmonary circulation including primary pulmonary hypertension and pulmonary hypertension secondary to congenital heart disease (Eisenmenger’s syndrome) still elude effective conventional therapy. These entities are progressive and often result in the death of the affected individual. Routine medical interventions are only partly effective in ameliorating some of the symptoms suffered by these patients. Since 1980 the real possibility of therapeutic lung and heart-lung transplantation has been recognized. There have been dramatic clinical successes with lung transplantation, particularly for patients with idiopathic pulmonary fibrosis,1 and with cardiopulmonary transplantation for those individuals afflicted by end-stage pulmonary vascular disease (either due to primary pulmonary hypertension or Eisenmenger’s syndrome).2


Hepatitis Transportation Cyclosporin Hunt Syphilis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Toronto Lung Transplant Group: Unilateral lung transplantation for pulmonary fibrosis. N Engl J Med 1986;314:1140–1145.CrossRefGoogle Scholar
  2. 2.
    Reitz BA, Wallwork JL, Hunt SA, et al: Heart-lung transplantation: Successful therapy for patients with pulmonary vascular disease. N Engl J Med 1982;306: 557–564.CrossRefGoogle Scholar
  3. 3.
    Wildevuur CRH, Benfield JR: A review of 23 human lung transplants by 20 surgeons. Ann Thorac Surg 1972;9:489–515.CrossRefGoogle Scholar
  4. 4.
    Veith FJ, Kamholz SL, Montefusco CM, et al: Lung transplantation 1983. Transplantation 1983;35:271–278.CrossRefGoogle Scholar
  5. 5.
    Veith FJ, Kamholz SL, Montefusco CM, et al: Lung transplantation, Part I: Advances in immunosuppression and surgical techniques. Hosp Phys 1984;20: 89–95.Google Scholar
  6. 6.
    Veith FL, Norin AJ, Montefusco CM, et al: Cyclosporin A in experimental lung transplantation. Transplantation 1981;32:474–481.CrossRefGoogle Scholar
  7. 7.
    Norin AJ, Emson EE, Kamholz SL, et al: Cyclosporin A as the initial immunosuppressive agent for canine lung transplantation: Short-and long-term assessment of rejection phenomena. Transplantation 1982;34:372–375.CrossRefGoogle Scholar
  8. 8.
    Norin AJ, Kamholz SL, Pinsker NL, et al: Concanavalin A dependent cell mediated cytotoxicity in bronchoalveolar lavage fluid: Correlation with lung allograft rejection in mongreal dogs during cyclosporine dose tapering. Transplantation 1986;42: 466–472.CrossRefGoogle Scholar
  9. 9.
    Fell SC, Mollenkopf FP, Montefusco CM, et al: Revascularization of ischemic bronchial anastomoses by an intercostal pedicle flap. J Thorac Cardiovasc Surg 1985;90:172–178.Google Scholar
  10. 10.
    Reitz BA, Hunt SA, Gaudiani V, et al: Clinical heart-lung transplantation. Transplant Proc 1983;15:256–259.Google Scholar
  11. 11.
    Ladowski JS, Kapelanski DP, Teodori MF: Use of autoperfusion for distant procurement of heart-lung allografts. Heart Transplant 1985;4:330–333.Google Scholar
  12. 12.
    Veith FJ: Lung transplantation in perspective. N Engl J Med 1986;314:1186–1187.CrossRefGoogle Scholar
  13. 13.
    Goldsmith J, Kamholz SL, Montefusco CM, et al: Clinical and experimental aspects of single lung transplantation. Heart and Lung 1987;16:231–236.Google Scholar
  14. 14.
    Kamholz SL, Veith FJ, Mollenkopf FP, et al: Single lung transplantation in paraquat intoxication. NYS J Med 1984;84:82–84.Google Scholar
  15. 15.
    Toronto Lung Transplant Group: Sequential bilateral lung transplantation for paraquat poisoning. J Thorac Cardiovasc Surg 1985;89:734–742.Google Scholar
  16. 16.
    Grossman RF, Maurer JR, Toronto Lung Transplant Group: Sequential improvement in pulmonary function following single lung transplantation for pulmonary fibrosis. Chest 1986;89:525S.Google Scholar
  17. 17.
    Jamieson SW, Reitz BA, Oyler PE, et al: Combined heart and lung transplantation. Lancet 1983;1:1130–1132.CrossRefGoogle Scholar
  18. 18.
    An appraisal of the criteria of cerebral death. A summary statement: A collaborative study. J Am Med Assoc 1977;237:982–986.Google Scholar
  19. 19.
    Goodman JM, Heck LL: Confirmation of brain death at bedside by isotope angiography. J Am Med Assoc 1977;238:966–968.CrossRefGoogle Scholar
  20. 20.
    Veith FJ, Fein JM, Tendler MD, et al: Brain death 1. A Status Report of Medical and Ethical Considerations. J Am Med Assoc 1977;238:1651–1655.CrossRefGoogle Scholar
  21. 21.
    Veith FJ, Fein JM, Tendler MD, et al: Brain death 2. A Status Report of Legal Considerations. J Am Med Assoc 1977;238:1744–1748.CrossRefGoogle Scholar
  22. 22.
    President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Guidelines for the determination of death. J Am Med Assoc 1981;246:2184–2186.CrossRefGoogle Scholar
  23. 23.
    Setzer N: Brain death: Physiologic definitions. Crit Care Clin 1985;1:375–395.Google Scholar
  24. 24.
    Uniform Anatomical Gift Act. The Georgetown Law Journal (appendix A) 1973;57:32–34.Google Scholar
  25. 25.
    Younger SJ, Allen M, Bartlett ET, et al: Psychological and ethical implications of organ retrieval. N Engl J Med 1985;313:321–324.CrossRefGoogle Scholar
  26. 26.
    Brodman RF, Veith FJ, Goldsmith J, et al: Multiple organ procurement from one donor. Heart Transpl 1985;4:254–257.Google Scholar
  27. 27.
    Cederna J, Toledo-Pereyra LM: Multiple organ harvesting. Selection, maintenance, surgical techniques. Contemporary Surgery 1984;25:15–26.Google Scholar
  28. 28.
    Rosenthal JT, Shaw BW, Hardesty RL, et al: Principles of multiple organ procurement from cadaver donors. Ann Surg 1983;198:617–621.CrossRefGoogle Scholar
  29. 29.
    Kamholz SL, Veith FJ: Single lung transplantation. J Thorac Cardiovasc Surg 1984;88:459–460.Google Scholar
  30. 30.
    Roper W, Bowen O: Medicare program: Criteria for medicare coverage of heart transplants. Fed Register 1987;52:10935–10951.Google Scholar
  31. 31.
    Canadian Multicenter Transplant Study Group: A randomized clinical trial of cyclosporine in cadaveric renal transplantation. N Engl J Med 1983;309:809.CrossRefGoogle Scholar
  32. 32.
    Burke CM, Theodore J, Dawkins KD, et al: Post-transplant obliterative bronchiolitis and other late sequelae in human heart-lung transplantation. Chest 1984;86:824.CrossRefGoogle Scholar
  33. 33.
    Provisional public health interagency recommendations for screening donated blood and plasma for antibody to the virus causing AIDS. Morbid Mortal Weekly Rept 1985;34:5–7.Google Scholar
  34. 34.
    Regan JJ: On transplant recipients: Survival of the richest? Medical Ethics 1987;2:12–11.Google Scholar
  35. 35.
    Iglehart JK: Transplantation: The problem of limited resources. N Engl J Med 1983;309:123–128.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1989

Authors and Affiliations

  • Stephan L. Kamholz
  • Frank J. Veith

There are no affiliations available

Personalised recommendations