LATE RESULTS AFTER HEART LUNG TRANSPLANTATION – A 20 YEAR EXPERIENCE
Bibliographic record
Abstract
A217 Aims: There is a paucity of data regarding late outcomes after heart lung transplantation (HLT). Most prior studies of any size combine data from single lung, double lung and HLT recipients. Methods: We present data from 47 (12 males, 35 females) HLT recipients performed between 1983 and 2003 at one centre. Indication for HLT included primary pulmonary hypertension (21), congenital heart disease with Eisenmenger’s Syndrome (15), pulmonary disease with secondary cardiac decompensation (10) and retransplantation (1). The procedure was performed via a sternotomy (31) or clamshell approach (16) and total ischemic time was 193 ± 100 minutes. Anti-lymphocyte globulin was used for induction immunosuppression followed by low dose prednisone (0.5 mg/kg/day initially and tapering) and calcineurin inhibitor when renal function stabilized. Results: 1 yr, 3 yr, 5 yr and 15 yr survival was 66%, 52%, 37%, and 11% respectively. Airway complications, bleeding and sepsis were responsible for most of the early deaths. All survivors beyond 1 yr developed some degree of bronchiolitis obliterans (BO) as assessed by spirometry and lung biopsy and this was the most common cause of late death. Cardiac rejection in the absence of BO was never seen. The rate of deterioration of BO was variable with some patients tolerating a moderately impaired FEV1 for many years with improved NYHA functional class compared to preoperative levels. Conclusions: Although chronic lung rejection continues to limit the success of HLT the procedure continues to be a viable option for highly selected patients with terminal cardiopulmonary disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".