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Biomedical subjects

J Wallwork

Publications and source records attributed to J Wallwork.

At least 127 records · Page 7Linked to original sources
PubMed1994

Risk factors for chronic rejection in heart and lungs--why do hearts and lungs rot?

The major cause of graft loss and patient death during the 1st yr after heart transplantation is progressive coronary occlusive disease. All survival curves show progressive and persistent graft loss over time. To improve the overall results of heart transplantation, attention must be directed to the etiology, prevention, and treatment of coronary occlusive disease. This condition affects both small and large vessels, and most probably results from a continuous immune insult that generates smooth muscle proliferation and subsequent development of atheromatous plaque. Multivariate analysis suggests that highly significant risk factors for the development of coronary occlusive disease include preoperative diagnosis of ischemic heart disease, age of recipient, and age of donor. Other risk factors, notably cytomegalovirus (CMV) infection, have not proved to be independent causes of coronary occlusive disease in our series. Diagnosis before the occlusive disease sets in, as well as the development of new therapeutic strategies, may prevent or delay the onset of coronary artery disease, thereby improving overall results of heart transplantation. Graft loss from lung transplantation after the 1st yr is associated with obliterative bronchiolitis. This final end-stage progressive loss of small airways can be seen not only in transplanted lungs but in lungs with chronic infection. It appears to be a final common pathway for lung injury, but following transplantation it is most likely to be mediated by rejection. Risk factor analysis in our series indicates that severe or persistent rejection in the first few months is associated with the subsequent development of obliterative bronchiolitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchiolitis Obliterans↗
PubMed1994

The rationale for xenotransplantation as a solution to the donor organ shortage.

This paper describes the current level of activity in organ transplantation and illustrates that human organ donors are never going to be sufficiently numerous to fill the clinical needs of potential organ recipients. Xenografts are proposed as an alternative solution and arguments are presented to suggest that xenografts from primates to man will not be an appropriate organ source in most cases. Finally the possibility of genetically engineering a pig to provide organs for human use is proposed.

Animals↗
PubMed1993

[Combination heart-lung transplantation in children: 4-year experience in London].

Since 1987, 21 children under 16 years of age have undergone combined heart and lung transplantation at Great Ormond Street Hospital, London. All children had terminal pulmonary or cardiopulmonary disease. Eight children died one day to 21 months after operation. Actuarial survival was 76% (SEM 10) at 1 year and 60% (SEM 12) at 3 and 4 years after transplantation. 13 children were alive, and all took part in all age-appropriate activities.

Adolescent↗