Combined heart-lung-liver transplantation possible in some patients:

            Peter Friend, MD and colleagues at the Churchill Hospital in oxford, UK has found that combined transplantation of the heart, lung and liver is a feasible and therapeutically effective procedure for a few selected patients. This kind of combined procedure may be a particularly viable option for patients with cystic fibrosis complicated by advanced liver disease. In their study the researchers reviewed the case records of 9 patients who underwent combined heart-lung-liver transplantation in Cambridge between 1986 and 1999. Eight patients had end-stage lung disease and advanced liver disease; 1 had end-stage liver disease with compromised lung function. All but 2 patients had cystic fibrosis. 2 patients experienced episodes of pulmonary rejection and 1 had episodes of pulmonary and liver rejection interestingly. The acute and chronic rejection rate was actually lower than that typically associated with heart lung transplantation. 1-year and 5-year actual survival rates of the group were 56% and 42%, respectively with the 5-year survival for the triple transplant operation similar to that of heart-lung transplantation. 3 patients died within a month of transplantation and 4 died between 4 months and 12 years post transplant. (Lancet, September 8, 2001)