Korean J Transplant.  2021 Dec;35(4):257-261. 10.4285/kjt.21.0029.

Heart transplantation in a patient with complex heart lung disease: a case report

• Kim SH
• Kim GY
• Oh JS
• Lee SY

• KMID: 2523676
• DOI: http://doi.org/10.4285/kjt.21.0029

Abstract

Heart disease is often accompanied by lung disease as they share the same risk factors. Heart or lung transplantation is regarded as a definitive treatment for the end-stage disease of each, while the expected median survival for lung transplantation is far shorter than heart transplantation. We present a case of refractory heart failure along with severe obstructive and restrictive lung disease that showed dramatic improvement in pulmonary function after single heart transplantation.

Keyword

Heart transplantation; Heart failure; Pulmonary function test; Lung transplantation; Case report

Figure

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  Fig. 1 (A) Chest radiograph. (B) Initial electrocardiogram. (C) Still image of echocardiography. (D) Chest computed tomography.

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  Fig. 2 Serial pulmonary function test results. FVC, forced vital capacity; PRED, predicted; FEV, forced expiratory volume; DLCO, diffusing capacity for carbon monoxide; PRE, pre-bronchodilator; POST, post-bronchodilator.

Reference

1. Hawkins NM, Petrie MC, Jhund PS, Chalmers GW, Dunn FG, McMurray JJ. 2009; Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology. Eur J Heart Fail. 11:130–9. DOI: 10.1093/eurjhf/hfn013. PMID: 19168510. PMCID: PMC2639415.

2. Boudestein LC, Rutten FH, Cramer MJ, Lammers JW, Hoes AW. 2009; The impact of concurrent heart failure on prognosis in patients with chronic obstructive pulmonary disease. Eur J Heart Fail. 11:1182–8. DOI: 10.1093/eurjhf/hfp148. PMID: 19887495.

3. McCullough PA, Hollander JE, Nowak RM, Storrow AB, Duc P, Omland T, et al. 2003; Uncovering heart failure in patients with a history of pulmonary disease: rationale for the early use of B-type natriuretic peptide in the emergency department. Acad Emerg Med. 10:198–204. DOI: 10.1197/aemj.10.3.198. PMID: 12615582.

4. Rutten FH, Cramer MJ, Grobbee DE, Sachs AP, Kirkels JH, Lammers JW, et al. 2005; Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease. Eur Heart J. 26:1887–94. DOI: 10.1093/eurheartj/ehi291. PMID: 15860516.

5. Khush KK, Cherikh WS, Chambers DC, Harhay MO, Hayes D Jr, Hsich E, et al. 2019; The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: thirty-sixth adult heart transplantation report - 2019 focus theme: donor and recipient size match. J Heart Lung Transplant. 38:1056–66. DOI: 10.1016/j.healun.2019.08.004. PMID: 31548031. PMCID: PMC6816343.

6. Naum CC, Sciurba FC, Rogers RM. 1992; Pulmonary function abnormalities in chronic severe cardiomyopathy preceding cardiac transplantation. Am Rev Respir Dis. 145:1334–8. DOI: 10.1164/ajrccm/145.6.1334. PMID: 1595999.

7. Wasserman K, Zhang YY, Gitt A, Belardinelli R, Koike A, Lubarsky L, et al. 1997; Lung function and exercise gas exchange in chronic heart failure. Circulation. 96:2221–7. DOI: 10.1161/01.CIR.96.7.2221. PMID: 9337193.

8. Cardiac asthma. Lancet. 1990; 335:693–4. DOI: 10.1016/0140-6736(90)90807-H.

9. Hosenpud JD, Stibolt TA, Atwal K, Shelley D. 1990; Abnormal pulmonary function specifically related to congestive heart failure: comparison of patients before and after cardiac transplantation. Am J Med. 88:493–6. DOI: 10.1016/0002-9343(90)90428-G. PMID: 2337106.

10. Meyer FJ, Borst MM, Zugck C, Kirschke A, Schellberg D, Kübler W, et al. 2001; Respiratory muscle dysfunction in congestive heart failure: clinical correlation and prognostic significance. Circulation. 103:2153–8. DOI: 10.1161/01.CIR.103.17.2153. PMID: 11331255.

11. Guazzi M. 2003; Alveolar-capillary membrane dysfunction in heart failure: evidence of a pathophysiologic role. Chest. 124:1090–102. DOI: 10.1378/chest.124.3.1090. PMID: 12970042.

12. Gehlbach BK, Geppert E. 2004; The pulmonary manifestations of left heart failure. Chest. 125:669–82. DOI: 10.1378/chest.125.2.669. PMID: 14769751.

13. Drakos SG, Kfoury AG, Gilbert EM, Horne BD, Long JW, Stringham JC, et al. 2007; Effect of reversible pulmonary hypertension on outcomes after heart transplantation. J Heart Lung Transplant. 26:319–23. DOI: 10.1016/j.healun.2007.01.012. PMID: 17403471.

14. Kirklin JK, Naftel DC, Kirklin JW, Blackstone EH, White-Williams C, Bourge RC. 1988; Pulmonary vascular resistance and the risk of heart transplantation. J Heart Transplant. 7:331–6. PMID: 3058901.