WordNet

a plane figure with rounded sides curving inward at the top and intersecting at the bottom; conventionally used on playing cards and valentines; "he drew a heart and called it a valentine"
the courage to carry on; "he kept fighting on pure spunk"; "you havent got the heart for baseball" (同)mettle, nerve, spunk
an inclination or tendency of a certain kind; "he had a change of heart" (同)spirit
a playing card in the major suit that has one or more red hearts on it; "he led the queen of hearts"; "hearts were trumps"
the locus of feelings and intuitions; "in your heart you know it is true"; "her story would melt your bosom" (同)bosom
the hollow muscular organ located behind the sternum and between the lungs; its rhythmic contractions move the blood through the body; "he stood still, his heart thumping wildly" (同)pump, ticker
a firm rather dry variety meat (usually beef or veal); "a five-pound beef heart will serve six"
able to perceive sound
an opportunity to state your case and be heard; "they condemned him without a hearing"; "he saw that he had lost his audience" (同)audience
(law) a proceeding (usually by a court) where evidence is taken for the purpose of determining an issue of fact and reaching a decision based on that evidence
the ability to hear; the auditory faculty; "his hearing was impaired" (同)audition, auditory sense, sense of hearing, auditory modality
a session (of a committee or grand jury) in which witnesses are called and testimony is taken; "the investigative committee will hold hearings in Chicago"
receive a communication from someone; "We heard nothing from our son for five years"
examine or hear (evidence or a case) by judicial process; "The jury had heard all the evidence"; "The case will be tried in California" (同)try
perceive (sound) via the auditory sense
either of two saclike respiratory organs in the chest of vertebrates; serves to remove carbon dioxide and provide oxygen to the blood

PrepTutorEJDIC

〈C〉『心臓』;胸 / 〈C〉(感情の中心をなす)『心』,気持ち / 〈U〉愛情,同情 / 〈U〉『勇気』,元気,熱意 / 《the ~》『中心』,内部,(物事の)本質,核心 / 〈C〉ハート形の物;(カードの)ハートの札
〈U〉『聴力』,聴覚〈U〉〈C〉(…を)『聞くこと』,(…の)聞き取り《+『of』+『名』》・〈C〉聞いてもらう機会,聞いてやること・聴取・聴聞会〈C〉(法廷などでの)尋問,審問,;(刑罰の減免を求める)釈明,意見陳述 / 〈U〉聞こえる距離(範囲)
〈音〉‘が'『聞こえる』,‘を'聞く(進行形にできない) / 〈人の言うこと〉‘に'『耳を傾ける』,‘を'注意深く聞く(listen);(裁判官などが)…の申し立てを聞く / 〈うわさ・ニュースなど〉‘を'『耳にしている』,聞いている / 『耳が聞こえる』 / 《しばしば命令形で》耳を傾ける,注意を向ける / 『うわさ』(『消息』)『を聞く』
移植;移植した物 / 移住 / (内臓などの)移植術
《しばしば複数形で》『肺』,肺臓

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/22 22:30:31」(JST)

wiki en

A heart–lung transplant is a procedure carried out to replace both heart and lungs in a single operation. Due to a shortage of suitable donors, it is a rare procedure; only about a hundred such transplants are performed each year in the USA.

Qualifying conditions

Most candidates for heart–lung transplants have life-threatening damage to both their heart and lungs. In the US, most prospective candidates have between twelve and twenty-four months to live. At any one time, there are about 250 people registered for heart–lung transplantation at the United Network for Organ Sharing (UNOS) in the USA, of which around forty will die before a suitable donor is found.

Conditions which may necessitate a heart–lung transplant include:

Congenital problems (defects present at birth) affecting the heart and lungs (48%);
Pulmonary hypertension (20%);
Cystic fibrosis (2%);
A second transplant after the first transplant was rejected or failed to operate satisfactorily (4%).

Candidates for a heart–lung transplant are usually required to be:

Under 55 years old;
Have no other medical conditions (e.g. AIDS, Diabetes, Hepatitis);
Mentally sound;
Capable of following a post-operative regimen of exercise and immunosuppressant drugs.

History

Dr. Norman Shumway laid the groundwork for heart lung transplantation with his experiments into heart transplantation at Stanford in the mid 1960s. Shumway conducted the first adult heart transplant in the US in 1968.

Building on his research at Stanford, Dr. Bruce Reitz performed the first successful heart–lung transplant on Mary Gohlke in 1981 at Stanford Hospital. The transplant team at Stanford is the longest continuously active team performing these transplants.

Procedure

The patient is anesthetised. When the donor organs arrive, they are checked for fitness; if any organs show signs of damage, they are discarded and the operation cancelled. Some patients are concerned that their organs will be removed and the donor organs won't be suitable. Since this is a possibility, it is standard procedure that the patient is not operated on until the donor organs arrive and are judged suitable, despite the time delay this involves.

Once suitable donor organs are present, the surgeon makes an incision starting above and finishing below the sternum, cutting all the way to the bone. The skin edges are retracted to expose the sternum. Using a bone saw, the sternum is cut down the middle. Rib spreaders are inserted in the cut, and spread the ribs to give access to the heart and lungs of the patient.

The patient is connected to a heart–lung machine, which circulates and oxygenates blood. The surgeon removes the failing heart and lungs. Most surgeons endeavour to cut blood vessels as close as possible to the heart to leave room for trimming, especially if the donor heart is of a different size than the original organ.

The donor heart and lungs are positioned and sewn into place. As the donor organs warm up to body temperature, the lungs begin to inflate. The heart may fibrillate at first – this occurs because the cardiac muscle fibres are not contracting synchronously. Internal paddles can be used to apply a small electric shock to the heart to restore proper rhythm.

Once the donor organs are functioning normally, the heart–lung machine is withdrawn, and the chest is closed.

Post-operation

Most patients spend several days in intensive care after the operation. If there are no complications (e.g. infection, rejection), some are able to return home after just two weeks in hospital. Patients will be given anti-rejection drugs, and antibiotics to prevent infection. A schedule of frequent follow up visits is necessary.

Statistics

The success rate of heart–lung transplants has improved significantly in recent years. The British National Health Service states that the survival rate is now around 85%, one year after the transplant was performed.^[1]

In 2004, there were only 39 heart–lung transplants performed in the entire United States and only 75 worldwide. By comparison, in that same year there were 2,016 heart and 1,173 lung transplants.^[2]

References

^ Heart lung transplant – Results at NHS24
^ Heart–lung transplant at Mount Sinai Hospital

External links

National Heart, Lung and Blood Institute (NHLBI)
Photograph of first successful heart–lung transplant

UpToDate Contents

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1. 心肺移植 heart lung transplantation
2. 難治性慢性閉塞性肺疾患（COPD）のマネージメント management of refractory chronic obstructive pulmonary disease
3. 肺移植：疾患に基づいた処置の選択 lung transplantation disease based choice of procedure
4. 肺移植：概要 lung transplantation an overview
5. 肺移植：レシピエント選定のための一般的ガイドライン lung transplantation general guidelines for recipient selection

English Journal

Five-year outcomes with alemtuzumab induction after lung transplantation.

Shyu S, Dew MA, Pilewski JM, Devito Dabbs AJ, Zaldonis DB, Studer SM, Crespo MM, Toyoda Y, Bermudez CA, McCurry KR.SourceDepartment of Medicine, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania.
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.J Heart Lung Transplant.2011 Jul;30(7):743-54. Epub 2011 Mar 21.
BACKGROUND: Induction therapy with alemtuzumab, followed by lower than conventional intensity post-transplant immunosuppression (eg, tacrolimus monotherapy), has been associated with reduced morbidity and mortality in abdominal and heart transplantation. We examined 5-year outcomes in lung recipient
PMID 21420318