Heart Transplantation
91 HEART TRANSPLANTATION
Daniel R. Meldrum M.D., Azad Raiesdana M.D., Jeffrey A. Breall M.D., John W. Brown M.D.
1. Who performed the first experimental heart-lung transplant?
Show answer
Alexis Carrel, a French-born American surgeon, developed the vascular techniques required for heart-lung transplantation and performed the first experimental heart-lung transplant in 1907. He transplanted the lungs, heart, aorta, and vena cava of a 1-week-old cat into the neck of a large adult cat. For devising the technique of vascular anastomosis and other outstanding accomplishments, Carrel received the Nobel Prize in 1912 (the first Nobel Prize awarded to a scientist working in an American laboratory).
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Lung Transplantation
92 LUNG TRANSPLANTATION
Daniel R. Meldrum M.D., Azad Raiesdana M.D., Jeffrey A. Breall M.D., John W. Brown M.D.
1. What are the general types of lung transplants?
Show answer
Single, double (bilateral), and heart-lung.
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91 HEART TRANSPLANTATION
Daniel R. Meldrum M.D., Azad Raiesdana M.D., Jeffrey A. Breall M.D., John W. Brown M.D.
1. Who performed the first experimental heart-lung transplant?
Show answer
Alexis Carrel, a French-born American surgeon, developed the vascular techniques required for heart-lung transplantation and performed the first experimental heart-lung transplant in 1907. He transplanted the lungs, heart, aorta, and vena cava of a 1-week-old cat into the neck of a large adult cat. For devising the technique of vascular anastomosis and other outstanding accomplishments, Carrel received the Nobel Prize in 1912 (the first Nobel Prize awarded to a scientist working in an American laboratory).
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KIDNEY AND PANCREAS TRANSPLANTATION
CONTROVERSIES
13. Is HLA (human leukocyte) matching still important?
Show answer
It is somewhat important. Historically, HLA matching was an important consideration when matching cadaver kidneys to recipients. With today’s improved immunosuppressive agents, many transplant surgeons believe that HLA matching is no longer critical. Six antigen match kidneys are still shared nationally and do enjoy some improvement in long-term graft survival. Donor organ quality remains the primary determinant in how well the transplanted organ functions. For example, a poorly matched living-donor kidney will still usually outlast a well-matched cadaveric kidney.
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Kidney & Pancreas Transplantation
90 KIDNEY AND PANCREAS TRANSPLANTATION
Thomas E. Bak M.D., Michael E. Wachs M.D., Igal Kam M.D.
1. What are the most common indications for kidney transplantation?
Show answer
End-stage renal disease (ESRD) caused by hypertension, diabetes, glomerulonephritis, and polycystic kidney disease.
Liver Transplantation. Controversies
CONTROVERSIES
12. Should liver transplants be performed in individuals with alcoholic liver disease?
Show answer
Transplant centers have strict criteria that alcohol-induced liver transplant recipients must undergo extensive psychological testing and abstain from alcohol before being placed on the waiting list. The recidivism rate (i.e., transplant patients who start drinking again) remains low. Financially, the cost is comparable, if not lower, than continued medical management of end-stage liver disease. We currently do provide care for other self-inflicted medical problems, such as cigarette smokers. The public must realize that people are not being pulled off bar stools and taken to the hospital for their transplant.
Liver Transplantation
89 LIVER TRANSPLANTATION
Thomas E. Bak M.D., Michael E. Wachs M.D., Igal Kam M.D.
1. When and where was the first liver transplant performed?
Show answer
Dr. Thomas Starzl performed the first operation on March 1, 1963, at the University of Colorado in Denver.
2. Is liver transplantation considered a safe and effective operation?
Show answer
Yes. Although still a major operation with significant risks, patient and graft survival have continuously improved. One-year survival should be well over 90% in major centers.
3. What are the most common indications for liver transplantation in the United States?
Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
