321. Die kombinierte Herz-Lungen-Transplantation

Abstract

936troduction of cyclosporin-A therapy. There were vascular problems of some sort (early or late) with 155 (= 38%) of our transplant operations: these were arterial in 143 cases and venous in 12. In 57 of these cases, the kidney was lost (14% rate of transplant failure with vascular cause). The failure rate is no higher in the case of difficult reconstruction procedures for detached or injured kidneys -which sometimes require the application of microsurgical techniques -providing they are carried out during the cold phase. Key words: Kidney transplantation -Arterial stenosis in transplanted kidneys -Cyclosporin-A. Combined Heart-Lung Transplantation Summary. We report our initial experience with combined heart-lung transplantation in three patients. They suffered from honeycomb lung, pulmonary hypertension after open Botallo's duct and Eisenmenger syndrome. Since all three patients underwent thoracic surgery prior to transplantation, they represented a high risk group. However, all survived the procedure. Immunosuppression consisted of cyclosporin, azathioprin and ATG, which was replaced by steroids after 2 weeks. All recipients were CMV-negative before grafting, but two donors were CMV-positive. Despite active immunization with CMV-hyperimmunoglobulin, both developed interstitional pneumonia, which led to death after 15 months in our first patient and required specific therapy in the other. The remaining patient enjoys normal graft function and is fully rehabilitated. Zusammenfassung