Document Detail


Early, aggressive open lung biopsy in heart transplant recipients.
MedLine Citation:
PMID:  3305835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fourteen open lung biopsies were done in 13 patients out of a total of 63 heart transplant recipients. All of the patients were receiving cyclosporine and azathioprine (Imuran) and had received prophylactic antithymocyte globulin or murine antihuman mature T cell (OKT3). Eight of the patients were receiving steroids, and five of the patients had been weaned off steroids. A fever of greater than 38.5 degrees C was present in all 13 patients. Hypoxia, defined as PO2 less than 60 on room air, was present in 11 of the 13 patients. One patient had to be intubated before surgery for respiratory failure. The chest x-ray film most often revealed bilateral interstitial infiltrates. The operative approach was by a small anterior thoracotomy in 12 patients and a posterolateral thoracotomy in two patients. A definitive diagnosis was made in 11 of the 14 open lung biopsies: three patients had Legionella, one had cytomegalovirus (CMV), one had a Pseudomonas infection, three had Pneumocystis, one patient had CMV and Pneumocystis, one patient had a pulmonary infarct, and one patient had a pulmonary infarct and CMV. Specific therapy was instituted in all these patients. In the three patients in whom no specific diagnosis was made, therapy was also changed and the use of antibiotics discontinued. There was no mortality in this group. Morbidity was minimal. No patient had excessive bleeding, and none of the patients required the transfusion of blood or blood products. Three patients required mechanical ventilatory support for longer than 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R Miller; N A Burton; S V Karwande; K W Jones; D B Doty; W A Gay
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart transplantation     Volume:  6     ISSN:  0887-2570     ISO Abbreviation:  J Heart Transplant     Publication Date:    1987 Mar-Apr
Date Detail:
Created Date:  1987-10-22     Completed Date:  1987-10-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8604172     Medline TA:  J Heart Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  96-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy / methods*
Female
Heart Transplantation*
Humans
Immunosuppression
Lung / pathology*
Lung Diseases / diagnosis*,  radiography
Male
Middle Aged
Opportunistic Infections / diagnosis*,  radiography
Radiography, Thoracic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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