The Transplantation and Replacement of Thoracic Organs: The Present Status of Biological and Mechanical Replacement of the Heart and Lungs

Description

It gives us great pleasure to contribute a short introduction outstanding book. This comprehensive work provides an to this important volume. immense fund of information, and will be an invaluable The transplantation of thoracic organs - heart,heart­ source of knowledge to physicians, surgeons, and scientists lung, lung - is a field of surgery that is expanding annually. for many years to come. The use of mechanical assist devices and artificial hearts to support patients awaiting transplantation is also developing rapidly, and further advances in this field may eventually April 1990 Christiaan Barnard lead to a totally implantable device that will function Cape Town, South Africa successfully for many years. It is therefore timely that such a volume as this should be made available to those who wish to be brought up-to­ date with the current state of knowledge in these related fields. The editors have done us all a great service in bringing together experts in every aspect of heart and Nazih Zuhdi lung transplantation and replacement to contribute to this Oklahoma City, USA Xl Preface The fields of the transplantation and replacement of thoracic Refinements in bioengineering have enabled mechanical organs have expanded immensely since the first human­ assist devices and the total artificial heart to support patients to-human heart transplant was performed in 1967. This successfully until a suitable donor becomes available. Front Matter....Pages i-xx Front Matter....Pages 1-1 Experimental Development and Early Clinical Experience....Pages 3-10 Indications, Selection and Management of the Recipient....Pages 11-17 The Concept and Diagnosis of Brain Death....Pages 19-25 Medico-legal Aspects....Pages 27-32 Donor Organ Availability and Transplant Coordination....Pages 33-40 Selection and Management of the Donor....Pages 41-49 Storage of the Donor Heart....Pages 51-61 Pretransplant Immunological Considerations....Pages 63-70 Anesthetic Management Including Cardiopulmonary Bypass....Pages 71-73 Surgical Technique of Orthotopic Heart Transplantation....Pages 75-80 Surgical Technique of Heterotopic Heart Transplantation....Pages 81-87 Immediate Postoperative Care and Maintenance Immunosuppressive Therapy....Pages 89-99 Physiology and Pharmacology of the Transplanted Heart....Pages 101-108 Immunobiology of Allograft Destruction....Pages 109-114 Pathology of Acute Rejection....Pages 115-125 Diagnosis and Management of Acute Rejection....Pages 127-142 Infectious Complications....Pages 143-160 Pathology of Graft Atherosclerosis (Chronic Rejection)....Pages 161-167 Diagnosis and Management of Graft Atherosclerosis (Chronic Rejection)....Pages 169-175 Retransplantation....Pages 177-182 Front Matter....Pages 1-1 Malignant Neoplasia in the Immunocompromised Patient....Pages 183-190 Other Complications of Transplantation and Immunosuppressive Therapy....Pages 191-202 Heterotopic Heart Transplantation — Indications and Special Considerations....Pages 203-207 Heart Transplantation in Infants and Children — Indications and Special Considerations....Pages 209-216 Psychiatric Aspects....Pages 217-221 Medico-social Aspects....Pages 223-226 Nutrition and Diet....Pages 227-231 Exercise Rehabilitation....Pages 233-240 Non-cardiac Surgery in Patients with Heart Transplants — Anesthetic and Operative Considerations....Pages 241-244 Non-cardiac Autopsy Findings in Patients with Heart (or Heart—Lung) Transplants....Pages 245-250 Results of Cardiac Transplantation and Factors Influencing Survival....Pages 251-255 Results of Cardiac Transplantation and Factors Influencing Survival....Pages 257-258 Front Matter....Pages 259-259 Experimental Background and Early Clinical Experience....Pages 261-266 Indications, Selection, and Management of the Recipient....Pages 267-272 Selection of the Donor; Excision and Storage of Donor Organs....Pages 273-282 Anesthetic Management....Pages 283-287 Surgical Technique of the Recipient Operation....Pages 289-298 Postoperative Management, Surgical Complications, Diagnosis and Management of Acute Rejection....Pages 299-305 Immunological Aspects....Pages 307-314 Pathology of Heart—Lung Transplantation....Pages 315-324 Front Matter....Pages 259-259 Infectious Complications....Pages 325-332 Physiology and Pharmacology of the Transplanted Lungs....Pages 333-339 Diagnosis and Management of Bronchiolitis Obliterans (Chronic Rejection): Retransplantation....Pages 341-347 Results of Heart—Lung Transplantation and Factors Influencing Survival....Pages 349-353 Front Matter....Pages 355-355 Experimental Background and Early Clinical Experience....Pages 357-361 Indications, Selection and Management of the Recipient....Pages 363-368 Selection of the Donor: Excision and Storage of the Lungs....Pages 369-374 Anesthesia for Single Lung Transplantation....Pages 375-379 Surgical Technique of Single Lung Transplantation....Pages 381-383 Surgical Technique of Double Lung Transplantation....Pages 385-389 Postoperative Management....Pages 391-398 Complications....Pages 399-405 Results of Lung Transplantation....Pages 407-409 Front Matter....Pages 411-411 Indications and Selection of Cardiac Support Device....Pages 413-416 Non-pulsatile Centrifugal Pumps....Pages 417-421 Pulsatile Ventricular Assist Devices....Pages 423-430 Total Artificial Hearts....Pages 431-444 Results of Mechanical Circulatory Support as a ‘Bridge’ to Cardiac Transplantation — Combined Registry Report....Pages 445-449 Front Matter....Pages 451-451 Experimental Background and Current Problems....Pages 453-461 Clinical Experience....Pages 463-466 Front Matter....Pages 469-469 Xenotransplantation: Overview....Pages 471-477 Pathology of Xenograft Rejection....Pages 479-483 Mechanisms and Possible Management of Hyperacute (Vascular, Humoral) or Xenograft Rejection....Pages 485-492 Clinical Experience....Pages 493-494 Front Matter....Pages 495-495 Cardiomyoplasty....Pages 497-501 Blood Pumps Constructed from Skeletal Muscle....Pages 503-511 Front Matter....Pages 513-513 Some Ethical and Logistic Issues in Transplantation....Pages 515-522 Heart and Lung Replacement: Future Perspectives....Pages 523-533 Back Matter....Pages 535-543