Chest
Clinical InvestigationsPost-Transplant Obliterative Bronchiolitis and Other Late Lung Sequelae in Human Heart-Lung Transplantation
Section snippets
Case 1
This 30-year-old man suffered from Holt-Oram syndrome (ventricular septal defect, atrial septal defect and skeletal abnormalities). Immediate postoperative recovery was complicated by mediastinal hemorrhage which required exploration on two occasions to tie off bleeding vessels in the posterior mediastinum. Impaired movement of the left hemidiaphragm associated with left lower lobe atelectasis and infection required bronchoscopy and removal of mucous plugs on postoperative day 9, and he made a
Discussion
The introduction of innovations into clinical management presents major problems with the assessment of risks vs benefits for individual patients. Not only are there the obvious problems of predicting potential benefits and the existence of predictable risks, but the problem of unexpected long-term risks also exists.2, 3
This has proved to be the case with human heart-lung transplantation. Many of the potential benefits have materialized. Approximately two thirds of a group of terminally ill
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