Follow-Up Studies
- Azathioprine vs cyclosporine in recipients of HLA-identical renal allografts
These two agents produce equally satisfactory outcomes in this immunologically favored group. The need for continued steroid therapy in these patients requires further study.
- Long-term follow-up of children after repair of atrial septal defects
The authors advocate repair of atrial septal defects as early as possible, definitely "before age 5, in order to minimize long-term complications of left-to-right shunting.
- Coronary artery disease in young women: risk factor analysis and long-term follow-up
Risk factors include hypertension, hypercholesterolemia, diabetes mellitus, familial coronary disease, and smoking. The long-term prognosis is excellent for those without advanced diabetes mellitus and renal failure.
- Lung transplantation: the Cleveland Clinic experience
BACKGROUND Lung transplantation has been steadily developing as a therapeutic option for end-stage lung disease.
METHODS Retrospective analysis of all 26 patients who underwent lung transplantation at the Cleveland Clinic Foundation between February 1990 and February 1992.
RESULTS Nineteen single-lung transplantations and seven bilateral lung transplantations were performed. The 1-year actuarial survival for all recipients was 65%. A trend was noted towards better survival in recipients with emphysema (100%) and poorer survival in those with pulmonary hypertension (37.5%). Fungal sepsis and reimplantation lung injury were the most common causes of death, and most deaths (8 of 9) occurred within the first 4 weeks. Of 119 pulmonary complications, 82% occurred in the first 3 months, with infection (39%) and acute rejection (29%) being the most common. Bacterial and fungal infections occurred mainly in the first month, and cytomegalovirus infections occurred mainly in the second and third months. The majority of survivors have shown improvement in functional status.
CONCLUSIONS The early perioperative and 1-month post-transplantation period appears critical to long-term survival. Even though the complications are numerous, they are usually manageable and, in general, do not result in long-term morbidity.