Cardiopulmonary transplantation: initial experience.

Cardiopulmonary transplantation may offer extended survival for patients with end-stage cardiopulmonary disease who were previously not potential transplant candidates. Clinical experience at this time has been limited to four patients at this institution. Cyclosporin A and the reduced need for large-dose immunosuppression may increase long-term survival for the cardiopulmonary transplant patient. The first recipient at this institution is alive and well more than 9 months after surgery and the second at 7 months; a third patient died on the third postoperative day as a result of complications related to a prolonged period of cardiopulmonary bypass necessitated by a severe coagulopathy; and a fourth is recovering 4 weeks after receiving his transplant (November 1981). Nursing assessment skills required for these patients are both physiological and psychological in nature. Each is of equal importance to ensure optimal recovery. Key factors that have been identified and discussed are the reimplantation response, compromised PaO2, compromised nutritional status, and the psychosocial impact.