Heart-lung transplantation forcystic fibrosis. 1:Assessment

Forty five patients withcystic fibrosis (age515years) wereassessed forheart-lung transplantation betweenSeptember 1987and March1990.Thetwomainconditions for acceptance were(i) life expectancy less than2 yearsand(ii) aseverely impaired quality of life. Patients wereaccepted ontoanactive waiting list (n=26), aprovisional waiting list (n=15), ornotaccepted (n=4). Selection wasmadeonclinical grounds withobjective measurements usedasanaidin assessment. Asexpected, themeanvalues for objective measures weresignificantly differentbetween patients ontheactive waiting list compared withtheprovisional waiting list/not accepted groupforresting heart rate(118/ minutev 101/minute), percentage ofideal weight (83-2% v 93-1%), forced expiratory volume atonesecond aspercent ofpredicted normal(27-3%v 47-6%),ShwachmanKulczycki score(33-6v 52.5), ChrispinNormanxrayscore(25.8 v22-1), 12minute walk(540m v 854m),andminimal oxygen saturation (81-5%v 92%).Psychological evaluation demonstrated a55%incidence of individual anda 50%incidence offamily morbidity. Ofthe26patients accepted ontotheactive waiting list, 11havebeentransplanted (mean waiting time3-3months), 10havediedwithin ameanof3-7months ofacceptance, andfive remain ontheactive list (mean5-6months).