En Bloc Heart‐Lung Transplantation: Past and Present. A Systematic Review
Bibliographic record
Abstract
BACKGROUND: En bloc heart-lung transplantation (HLTx) has been utilized for the past 50 years for the treatment of end-stage heart and lung disease, with significant evolution in the field over that time. This is a systematic review of HLTx and a description of the evolution and outcomes in this patient population. METHODS: Pubmed and Embase were searched for all articles on HLTx from the time of database inception. A total of 1513 articles were screened, and after exclusion, 29 were included in this systematic review. RESULTS: Reported cases of HLTx were more common in the early era (before 2000), for the indications of cystic fibrosis, Eisenmenger's syndrome, and pulmonary hypertension. In the contemporary era (2000-present), patients were not as commonly transplanted for cystic fibrosis, with pulmonary hypertension and congenital heart disease comprising the majority of cases. Rates of short-term mortality tended to be lower in more recent studies, with only recent studies reporting long-term survival. DISCUSSION: HLTx has evolved substantially. In tandem with isolated heart and lung transplantation, the indications for transplant, medical therapy, and outcomes have changed over time. While HLTx is used less frequently in contemporary times compared to the early days of cardiothoracic transplantation, indications for HLTx continue to exist, and the use of HLTx will continue to be indicated. Centers with experience in HLTx should continue to report trends in patient management and outcomes, to continue to guide continued refinement in the field of HLTx.
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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 | 0.005 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.011 | 0.014 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".