Human leukocyte antigen compatibility in heart-lung transplantation.

The relationship of heart-lung allograft-related death and obliterative bronchiolitis (OB) to human leukocyte antigen (HLA) matching was studied in 40 consecutive heart-lung transplant patients operated on between March 1981 and September 1986. Mismatch was defined as an antigen present in the donor but not in the recipient. Patients with only one antigen identified at a given locus were presumed to be homozygous for that antigen.

Primary pulmonary hypertension. Length of survival in patients referred for heart-lung transplantation.

The paucity of data on the natural history of primary pulmonary hypertension (PPH), and the observation that some patients awaiting heart-lung transplantation (HLT) appeared to be living longer than expected, led us to analyze the survival data of patients with PPH who had been referred for consideration of HLT. Ninety patients (female: male = 3.6:1) met clinical and hemodynamic criteria for PPH.

Pulmonary function in advanced pulmonary hypertension.

Pulmonary mechanical function and gas exchange were studied in 33 patients with advanced pulmonary vascular disease, resulting from primary pulmonary hypertension in 18 cases and from Eisenmenger physiology in 15 cases. Evidence of airway obstruction was found in most patients. In addition, mean total lung capacity (TLC) was only 81.

The spectrum of cytomegalovirus infection following human heart-lung transplantation.

Data were analyzed from 19 long-term survivors of cardiopulmonary transplantation in this institution, including nine patients with normal pulmonary function and 10 recipients with posttransplant obliterative bronchiolitis. In all cases, donor cytomegalovirus titers (IgG), preoperative recipient titers (IgG), and serial postoperative recipient titers (IgM, IgG, and complement fixation) were available. In addition, surveillance cytomegalovirus cultures and pulmonary function tests were obtained prospectively after surgery in all 19 patients.

The use of fibreoptic bronchoscopy with sterile catheter in the diagnosis of pneumonia.

The use of fibreoptic bronchoscopy with sterile catheter sampling of pulmonary secretions was evaluated in 70 patients with a provisional diagnosis of pneumonia. In 37 patients quantitative analysis of the sterile catheter isolates was performed (colony forming units (CFU) per ml). Potential bacterial pathogens were isolated in 37 patients and in the quantitative analysis, 14 of 22 isolates were grown in counts greater than or equal to 10(3) CFU/ml.

Determinants of the slope of phase III of the single breath nitrogen test.

To assess whether the slope of phase III of the single breath nitrogen (SB-N2) test correlates better with inhomogeneity of the elastic properties within a lung or with peripheral airway inflammation, pressure-volume (PV) curves and SB-N2 tests were performed in 28 excised human lungs, including 11 emphysema-free and 17 emphysematous lungs. The degrees of emphysema and membranous as well as respiratory bronchiolar inflammation were graded in a semi-quantitative manner. The PV curves were analysed using an exponential curve fit, yielding the exponent K which is proportional to total incremental compliance.