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Biomedical subjects

C M Dennis

Publications and source records attributed to C M Dennis.

4 recordsLinked to original sources

Heart-lung-liver transplantation.

We report three patients with cystic fibrosis and one patient with primary biliary cirrhosis and plexogenic pulmonary hypertension who have undergone heart-lung-liver transplantation as a combined procedure. Liver transplantation was necessary in the three patients with cystic fibrosis because of portal hypertension secondary to either hepatic fibrosis or established cirrhosis in addition to their advanced lung disease. Three of the four patients were alive at 20, 50, and 100 months after transplantation (one patient with cystic fibrosis died on day 16 of pneumonia) with well-preserved pulmonary function (forced expiratory volume in 1 second 110%, 49%, and 100% predicted, respectively), normal hepatic function and New York Heart Association class 1 performance status. Heart-lung and concurrent liver transplantation is a feasible and successful procedure with a satisfactory long-term outcome in selected patients with advanced pulmonary and hepatic disease.

Adult↗

Donor and recipient predicted lung volume and lung size after heart-lung transplantation.

Lung volumes after heart-lung transplantation (HLT) were recorded and compared with measurements at the time of assessment for surgery and the predicted values for recipients. The influence of donor lung size and recipients' underlying lung disease was evaluated. All patients underwent HLT between April 1984 and April 1991, and only those 82 who survived for at least 6 mo were studied. Mean total lung capacity (TLC) at preoperative assessment was 112% (SD = 28%) of the value predicted for recipients. One month after HLT, mean TLC was 83% (SD = 15%) of the predicted value but increased to 100% (SD = 15%) after 9 mo. No further change in average TLC occurred for 5 yr subsequently. The mean TLC of patients with emphysema before surgery was 164% (SD = 26%) of the predicted value and fell to the predicted value within 1 mo of HLT. The TLC in patients with primary pulmonary hypertension before surgery was close to the predicted value, but postoperative predicted TLC was achieved later than in emphysema patients. A donor-versus-recipient difference in TLC of more than 1L at the time of assessment did not influence the adaptation to the predicted value. FEV1 and vital capacity (VC) rose from means of 70% (SD = 25%) and 63% (SD = 20%) at 1 mo to 96% (SD = 27%) and 91% (SD = 18%), respectively, at 9 mo after HLT. After HLT, TLC returns to the predicted value for the recipient, and not to the preoperative TLC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗