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February 13, 1987

New Techniques Enable 'Heartless' Lung Transplants

JAMA. 1987;257(6):728. doi:10.1001/jama.1987.03390060018004

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RECENT IMPROVEMENTS in immunosuppression, surgical technique, and graft preservation have breathed new life into lung transplantation. The procedure is being revived at Toronto General Hospital, Stanford (Calif) Medical Center, and Harefield Hospital in Great Britain.

Joel D. Cooper, MD, director of the Toronto Lung Transplant Group at the University of Toronto, says that the availability of cyclosporine and the use of an omental wrap have made single- and double-lung transplantation viable alternatives to heart/lung transplantation in patients with end-stage interstitial lung disease who have good cardiac function. The Toronto group has performed two successful double-lung transplants since early December 1986 and five successful single-lung transplants since 1983. And surgeons at Harefield Hospital have performed three double-lung procedures since December, but have not reported results.

Cooper thinks the recent successes are reversing lung transplantation's dismal record. Single-lung transplantation was introduced in the early 1960s. It was abandoned a decade later after