Lung Transplantation - Tapa blanda

Clinical lung transplantation has seen an early start within the history of solid organ trans­ plantation, marked by the 1963 first lung transplant by James D. Hardy. This was prompted by the seemingly easy way of joining the transplanted organ to the recipient by me ans of a few well-defined anastomoses, i.e. bronchus, pulmonary artery and pulmonary vein carry­ ing left atrial cuff. The following decade thus witnessed a number of such mostly unilateral lung transplants in several centres, in Germany represented by the two only lung transplants performed by E. S. Bücherl, then at the Neukölln City Hospital in Berlin in 1969. As with most other such attempts these two patients suffered early and lethai graft failure. There was only one single lung transplant patient who lived up to ten months after the transplant at Gent, Belgium, having been operated on by Derom in 1969. The alm ost universal failure during this initial phase was attributed to bronchial anasto­ motic insufficiency, pulmonary infection of either the transplanted lung or the left-in-place contralateral lung and a far-reaching lack of knowledge how to cope with transplant rejec­ tion. In the early 1970s it had become gene rally accepted that lung transplantation could not be performed successfully.

The very first clinical lung transplantation in 1963 was not too promising a start. In the years that followed, immense obstacles had to be surmounted and for a while nobody believed in the success of such an operation. Fortunately pioneers as Reitz and Cooper did not abandon the idea and it is also due to them that lung transplantation has found widespread application. By now well above 10.000 lung transplants have been carried out world-wide in specialised centres, such as the German Heart Centre at Berlin. Thus essential knowledge and experience has been gained, however, postoperative complications have not yet ceased to pose serious problems to the transplantation community. That among other topics, was a key issue at this Berlin symposium, the proceedings of which are compiled in this volume. They reflect the state of thought and experience in lung transplantation at the beginning of the second millennium. Most of these articles are of high value to today's specialists.