Organ Transplantation A Clinical Guide Organ Transplantation A Clinical Guide Edited by Andrew A. Klein Consultant, Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK Clive J. Lewis Consultant Cardiologist and Transplant Physician, Papworth Hospital, Cambridge, UK JorenC.Madsen Director of the MGH Transplant Center, Section Chief for Cardiac Surgery, and W. Gerald and Patricia R. Austen Distinguished Scholar in Cardiac Surgery, Massachusetts General Hospital, Boston, MA, USA CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, Sao˜ Paulo, Delhi, Tokyo, Mexico City Cambridge University Press The Edinburg Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521197533 c Cambridge University Press 2011 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2011 Printed in the United Kingdom at the University Press, Cambridge A catalogue record for this publication is available from the British Library. Library of Congress Cataloguing in Publication data Organ transplantation : a clinical guide / edited by Andrew Klein, Clive J. Lewis, Joren C. Madsen. p. ; cm. Includes bibliographical references and index. ISBN 978-0-521-19753-3 (hardback) 1. Transplantation of organs, tissues, etc. 2. Transplantation immunology. I. Klein, Andrew. II. Lewis, Clive J., 1968– III. Madsen, Joren C., 1955– [DNLM: 1. Organ Transplantation. 2. Transplantation Immunology. WO 660] RD120.7.O717 2011 617.95 – dc22 2011002165 ISBN 978-0-521-19753-3 Hardback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this book to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use. Contents List of contributors vii Foreword xi Preface xiii List of abbreviations xv Section 1 – General 10 Management during surgery 88 Kate Drummond and Andrew A. Klein 1 Historical perspectives 1 John Dunning and Sir Roy Calne 11 Postoperative care and early complications 94 2 Immunological principles of acute Mandeep R. Mehra rejection 9 FadiG.Issa,RyoichiGoto,andKathrynJ.Wood 12 Long-term management and outcomes 102 3 Immunosuppression: Past, present, Hari K. Parthasarathy and Clive J. Lewis and future 19 Vineeta Kumar and Robert S. Gaston 13 Pediatric heart transplantation 112 Jacob Simmonds and Michael Burch 4A Major complications – cancer 31 Bimalangshu R. Dey and Thomas R. Spitzer 4B Major complications – pathology of Section 3 – Lung chronic rejection 38 14 Recipient selection 122 Yael B. Kushner and Robert B. Colvin J.S. Parmar 4C Major complications – infection 46 15 Living donor lobar lung Camille Nelson Kotton transplantation 128 5 Organ donor management and Hiroshi Date procurement 53 16 Surgical procedure 133 Edward Cantu III and David W. Zaas Faruk Ozalp,¨ Tanveer Butt, and Stephan V. B. S c hu e l e r Section 2 – Heart 17 Management during surgery 138 David Ip and Peter Slinger 6 Recipient selection 63 R.V. Venkateswaran and Jayan Parameshwar 18 Postoperative care and early complications 145 7 Donor heart selection 70 Vlad Vinarsky and Leo C. Ginns KiranK.KhushandJonathanG.Zaroff 19 Long-term management and 8 Ventricular assist devices 76 outcomes 155 DavidG.HealyandStevenS.L.Tsui Paul Corris 9 Surgical procedure 83 20 Pediatric lung transplantation 164 R.V. Venkateswaran and David P. Jenkins Stuart C. Sweet and Samuel Goldfarb v Contents Section 4 – Liver 33 Pediatric kidney transplantation 278 Khashayar Vakili and Heung Bae Kim 21 Recipient selection 173 Alex Gimson 22 Living donor liver transplantation 182 Section 6 – Other abdominal organs Koji Hashimoto, Cristiano Quintini, and 34 Pancreatic transplantation 286 Charles Miller Dixon B. Kaufman 23 Surgical procedure 190 35 Pancreatic islet transplantation 295 SimonJ.F.HarperandNevilleV.Jamieson Heidi Yeh and James F. Markmann 24 Peri-operative care and early 36 Intestinal transplantation 303 complications 199 Stephen J. Middleton, Simon M. Gabe, John Klinck and Andrew J. Butler Neville V. Jamieson, and Andrew J. Butler 25 Long-term management and outcomes 212 William Gelson and Graeme J.M. Alexander Section 7 – Other 37 Composite tissue allotransplantation: 26 Pediatric liver transplantation 220 Face transplantation 313 Hector Vilca-Melendez and Giorgina Maria Siemionow and Can Ozturk Mieli-Vergani 38 Hematopoietic stem cell transplantation 320 Section 5 – Kidney Charles Crawley and Thomas R. Spitzer 27 Recipient selection 231 39 Corneal transplantation 330 Ernest I. Mandel and Nina E. Tolkoff-Rubin Yvonne H. Luo and D. Frank P. Larkin 28 Sensitization of kidney transplant recipients 238 Nick Pritchard Section 8 – The transplant service 40 UK and European service – legal and 29 Live donor kidney donation 248 operational framework 335 Arthur J. Matas and Hassan N. Ibrahim ChrisJ.RudgeandAxelO.Rahmel 30 Surgical procedure 253 41 US transplant service – legal and Paul Gibbs operational framework 347 31 Peri-operative care and early Walter K. Graham, Richard S. Luskin, and complications 258 Francis L. Delmonico Lorna Marson and John Forsythe 42 Conclusions 355 32 Long-term management and Clive J. Lewis outcomes 265 Sharon Mulroy and John D. Firth Index 357 Color plate section falls between pages 181 and 182. vi Contributors Graeme J.M. Alexander, MA, MD, FRCP Charles Crawley Consultant Hepatologist, Addenbrooke’s Hospital Consultant, Department of Hematology, Cambridge, UK Addenbrooke’s Hospital, Cambridge, UK Heung Bae Kim, MD Hiroshi Date, MD Assistant Professor of Surgery, Harvard Medical Professor, Department of Thoracic Surgery, Kyoto School, and Director, Pediatric Transplant Center, University Graduate School of Medicine, Children’s Hospital Boston, Boston, MA, USA Kyoto, Japan Michael Burch Francis L. Delmonico, MD Lead Transplant Consultant, Consultant Cardiologist, Medical Director, New England Organ Bank, and Great Ormond Street Hospital for Sick Children, Professor of Surgery, Harvard Medical School, London, UK Massachusetts General Hospital, Boston, MA, USA Andrew J. Butler, MD Bimalangshu R. Dey, MD, PhD Consultant, Department of Transplantation Surgery, Bone Marrow Transplant Program, Department of Addenbrooke’s Hospital, Cambridge, UK Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA Tanveer Butt, FRCS Department of Cardiopulmonary Transplantation, Kate Drummond, MD TheNewcastleuponTyneHospitalsNHSFoundation Fellow, Anaesthesia and Intensive Care, Papworth Trust (NUTH), Freeman Hospital, High Heaton, Hospital, Cambridge, UK Newcastle upon Tyne, UK John Dunning, MD Roy Calne, MD Consultant Cardiothoracic Surgeon, Papworth Yeah Ghim Professor of Surgery at the National Hospital, Cambridge, UK University of Singapore, Singapore John D. Firth, DM, FRCP Edward Cantu III, MD Consultant Physician and Nephrologist, Cambridge Associate Surgical Director of Lung Transplantation, University Hospitals Foundation Trust, University of Pennsylvania, Philadelphia, PA, USA Cambridge, UK Robert B. Colvin, MD John Forsythe, MD Department of Pathology, Massachusetts General Consultant Transplant Surgeon, Royal Infirmary of Hospital, and Harvard Medical School, Boston, Edinburgh, Edinburgh, UK MA, USA Simon M. Gabe Paul Corris, MB, FRCP Lennard Jones Intestinal Failure Unit, St Mark’s Professor, Department of Respiratory Medicine, Hospital, Northwick Park, Harrow, Freeman Hospital, Newcastle upon Tyne, UK London, UK vii Contributors Robert S. Gaston, MD, MRCP David G. Healy, PhD, FRCSI (C-Th) Endowed Professor, Transplant Nephrology, and Honorary Fellow, Department of Cardiothoracic Medical Director, Kidney and Pancreas Surgery, Papworth Hospital, Cambridge, UK Transplantation, Division of Nephrology, University of Alabama at Birmingham, Hassan N. Ibrahim, MD Birmingham, AL, USA Department of Medicine, University of Minnesota, Minneapolis, MN, USA William Gelson, MD, MRCP David Ip, MBBS, FANZCA Consultant Surgeon, Department of Transplant Surgery, Addenbrooke’s Hospital, Cambridge, UK Anaesthesia Fellow, Toronto General Hospital, Toronto, ON, Canada Paul Gibbs Fadi G. Issa, MA, BMBCh, MRCS Consultant Surgeon, Department of Transplant Clinical Research Fellow, Nuffield Department of Surgery, Addenbrooke’s Hospital, Cambridge, UK Surgery, University of Oxford, Oxford, UK Alex Gimson Neville V. Jamieson Consultant Physician,