Lung Transplantation

Lung Transplantation

bookshelf Those readers of CHEST interested in serving as reviewers for “Bookshelf” are asked to notify the department editor, Lee K. Brown, MD, FCCP,...

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bookshelf Those readers of CHEST interested in serving as reviewers for “Bookshelf” are asked to notify the department editor, Lee K. Brown, MD, FCCP, at the following address: Sleep Disorders Center of The University of New Mexico, 1101 Medical Arts Avenue NE, Building 2, Albuquerque, NM 87102. Please indicate your field(s) of expertise (pulmonary, cardiology, cardiothoracic surgery, critical care, or sleep), and include your curriculum vitae if available. In appreciation for completed reviews, authors may retain the book or software for their own use.

Lung Transplantation By Nicholas R. Banner, Julia M. Polak, and Magdi Yacoub, eds. Cambridge, UK: Cambridge University Press, 2003; 428 pp; $160 Lung Transplantation is a comprehensive, multiauthored book on lung transplantation that conveys the excitement and privilege of being involved in this heroic endeavor, and the anticipation of expected advances in lung transplantation science. The text is divided into three parts. The first part deals with individual pulmonary diseases that represent indications for transplantation. These conditions are appropriately discussed from the perspective of the issues and challenges that they present for transplantation. The second part reviews important aspects of lung and heart-lung transplantation with special attention to areas not often covered in general transplantation textbooks. These include anesthesia and intensive care management, hematologic considerations, and the growing field of pretransplantation psychodynamics as it affects posttransplantation care and survival. The final part encompasses state of the art reviews on tissue engineering, xenotransplantation, prospects for an artificial lung, and future directions. In part one, the in-depth treatise on primary pulmonary hypertension contrasts with the more focused reviews of other entities, in which the discussions center on the disease as an indication for transplantation. This may account for the seemingly disparate quality of the initial chapters. There is also some redundancy in this part of the book that may be helpful to newcomers to the field but not to the seasoned, already-involved “transplantologist.” The reader will note several excellent chapters that are surely destined to serve as standard references, as they provide important insights into mechanisms of disease or great experiential knowledge. Most notable are those covering pulmonary hypertension, genetics and right ventricular function, explant and transplant pathology, immunologic mechanisms of graft injury, and transplant imaging. Other chapters provide sound advice on the evaluation and management of the transplant patient (eg, those on bronchiectasis, anesthesia and ICU care, and hematology). There is also an excellent discussion of similarities and differences in the practice of lung transplantation across several continents. Lung Transplantation is primarily written for the medical transplant physician and for committed newcomers to the field. In addition to serving the usual functions of a textbook as an organized review of a field of study, this particular volume also represents an invaluable contribution to the practice of lung transplantation: the dissemination of knowledge gained by experienced centers, which is usually obtained only by the passage of years and the performance of substantial numbers of transplants. This text will also be of great help to practitioners in other disciplines (surgery, intensive care, pathology, cardiology, infectious diseases, nephrology, psychology, psychi1968

atry) involved in the care of lung transplant patients or in the study of the science of transplantation. Maria L. Padilla, MD, FCCP Manhasset, NY

Handbook of Physiology, Section 2: The Cardiovascular System, Volume I: The Heart By Harry A. Fozzard, and R. John Solaro, eds. New York, NY: Oxford University Press, 2002; 822 pp; $195 When it comes to education in the physiologic sciences, many of us enjoyed the wisdom handed down from Arthur Guyton, or perhaps from one of several other general medical physiology texts. Such is the standard in most medical schools, and it is quite often the case in graduate schools. While these tomes provide invaluable information regarding systems physiology, they are often lacking in molecular and cell physiology. Thus, many of us escape formal education without a clue as to the meaning of a “calcium spark.” Moreover, in the decade or so it takes for many to complete medical training, residency, and subspecialty training, great advances in physiologic science will undoubtedly have occurred. Even those of us directly or peripherally involved in basic physiology struggle to stay current on novel or emerging concepts. Fortunately, the American Physiologic Society has taken on the noble task of publishing compendious “handbooks” that provide a greater wealth of information than most students will ever have the opportunity to enjoy. One book of particular interest to the readers of CHEST is Handbook of Physiology, Section 2: The Cardiovascular System, Volume I: The Heart. This text provides detailed chapters that cover the contractile and conductive functions of the heart. The book begins with a wonderful anatomic chapter featuring a wide array of structural electron microscopic photographs of the cardiac muscle. This is followed by a chapter on myocardial growth, including mathematical methods and a great many figures describing myocyte density, volume, etc, throughout a life span and across gender. Thereafter begin the chapters on molecular physiology, with sections on caveolae and gap junctions, cardiac innervation, and excitation-contraction coupling. Midway through the text are sections on conduction, covering both dynamics of ion channels as well as the behavior of the wavefront through the myocardial tissue. Overall, the depth of information is impressive, yet well communicated and well illustrated. The book is not without small drawbacks. For one, the text could easily have been formatted into sections and subsections. Though the chapters follow a reasonably logical order, the casual reader would certainly benefit from a more structured approach. Also, the chapters on pathophysiology are cursory, and the concluding chapter seems more like an introduction to a heart failure text. Since this is a physiology book, perhaps in-depth discussions of cardiovascular pathology would constitute “mission creep.” However, there is likely to be some disappointment in this regard for readers in the health professions. Lastly, one wonders what the definition of “handbook” should be; my feeling is that it should easily fit into one hand. At a comprehensive and hefty 822 pages, the American Physiologic Society handbook on cardiac physiology requires both hands and a large desk. Matthew J. Campen, PhD Albuquerque, NM Bookshelf