Surgeons' qualifications.
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Accreditation↗
Biomedical subjects
T English
Publications and source records attributed to T English.
The coronary arteries of the transplanted human heart: studies of the development of disease based on serial angiography.
291 coronary angiograms were performed routinely 1 to 8 years after cardiac transplantation in 116 patients operated on at Papworth Hospital between January 1979 and September 1986. In this setting, as in others, angiography tends to underestimate the amount of disease present, and the patterns of angiographic abnormality are various. The actuarial probability of freedom from angiographic evidence of coronary occlusion is 79% at 2 years, 76% at 3 years, 60% at 4 years, 57% at 5 years. We have defined two disparate groups designated 'fast disease' and 'slow disease', being respectively those who have angiographic and/or pathologic evidence of disease at two years, and those who have normal coronary angiograms at 5 years. In comparing features of these two groups, donor age, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride level differ, though significantly only for the high density fraction.
Adult↗
Donor heart preservation survey.
A questionnaire requesting information on donor heart preservation technique and outcomes during the first 6 months of 1990 was circulated to heart transplantation centers worldwide. Seventy-nine usable replies representing 1371 clinical transplant operations were received. Twenty-seven percent of the respondents reported using some form of donor pretreatment. Most (90%) used single flush cardioplegic induction with the use of eight different types of cardioplegic solutions, only 5% of which were oxygenated. Six different types of storage media were used, and the coolant was melting ice in 66% of the centers. Storage temperatures between 0 degrees C and 7 degrees C were reported, with 78% of the respondents using 4 degrees C storage. Fifty-five percent of the centers used some form of reperfusion modification. No statistically significant associations were noted between outcome and technique, apart from the use of storage medium in which the use of cardioplegic solution conferred a 2.5 times increase in deaths compared with cold saline. The results of this questionnaire provide evidence for the diversity of techniques currently used for donor heart preservation, reflecting the lack of any one optimal method.
Cardioplegic Solutions↗