Intensive care on one case of combined heart-liver transplantation
10.3760/cma.j.issn.0254-1785.2012.09.007
- VernacularTitle:心肝联合移植一例报告
- Author:
Jiawei SHI
;
Nianguo DONG
;
Jinping LIU
;
Jing ZHANG
;
Jie CAI
;
Ping LI
;
Jianfeng CHEN
;
Shiliang XIAO
;
Qichang ZHENG
;
Jun XIONG
- Publication Type:Journal Article
- Keywords:
Combined heart-liver transplantation;
Perioperative care
- From:
Chinese Journal of Organ Transplantation
2012;33(9):536-538
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the diagnosis and treatment of one case of combined heart liver transplantation. Methods On November 24, 2011, one case of combined heart-liver transplantation was performed on a patient with Ebstein's anomaly and tricuspid valve replacement after 5 years,complicated with congestive cirrhosis,liver failure dccompensation,preoperative heart failure Ⅲ degree and B grade of liver function Child-Pugh score. The operation was done with the graded cardiopulmonary bypass assisted mode:first creating the vena cava-aortic bypass to complete heart transplantation, second creating the femoral vein-ascending aorta bypass to complete liver transplantation,and third stopping and neutralizing.The aortic cross-clamping time was 54 min and the an hepatic phase was 38 min.The total time of three times of cardiopulmonary bypass was 199 min and the total time-consuming of operation was 517 min. The patient was given basiliximab +methylprednisolone for immune induction therapy, and tacrolimus + mycophenolate mofetil +prednisone solution for anti-rejection. After operation, liver protecting treatment, anti-infection therapy and nutrition support therapy were given.Results The recipient died of multiple organ failure after 78 days.The mechanical ventilation treatment duration for this recipient was 78 days and ECMO adjuvant therapy for postoperative hypoxemia time lasted 63 days.Conclusion The combined heart liver transplantation is an effective measures for treatment of heart and liver failure.
