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The Annals of Thoracic Surgery, Vol 45, 626-633, Copyright © 1988 by The Society of Thoracic Surgeons
GA Patterson, JD Cooper, B Goldman, RD Weisel, FG Pearson, PF Waters, TR Todd, H Scully, M Goldberg and RJ Ginsberg
Lung transplantation has become a successful method in the therapy for
end-stage pulmonary disease. While single-lung transplantation provides
benefit to patients with pulmonary fibrosis, bilateral lung transplants are
required for septic or emphysematous lung disease. We describe the
technique employed in 6 patients to transplant en bloc both lungs with the
recipient heart left in place. The lungs are connected by a left atrial
cuff, main pulmonary artery, and trachea. The completed implantation has a
tracheal anastomosis securely wrapped in omentum, a left atrial anastomosis
posterior to the heart, and a pulmonary artery anastomosis anteriorly.
Airway ischemia resulted in the death of 1 patient. This procedure allows
complete excision of all diseased pulmonary tissue, retention of the
recipient's own heart, and separate excision of the donor heart for use in
another recipient, thereby markedly increasing the supply of donor lungs
for transplantation.
ARTICLES
Technique of successful clinical double-lung transplantation
Department of Surgery, University of Toronto, Ont, Canada.
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