321. Die kombinierte Herz-Lungen-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.