Clinical practice of 9 cases of bilateral sequential lung transplantations
- VernacularTitle:序贯式双肺移植九例报告
- Author:
Jianxin SHI
;
Chengxin GAO
;
Yuan QIN
- Publication Type:Journal Article
- Keywords:
Lung transplantation;
Extracorporeal membrane Oxygenation
- From:
Chinese Journal of Organ Transplantation
1996;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the surgical indications and safety of bilateral sequential lung transplantation in 9 cases.Methods Between Jan.2003 to June 2005,9 bilateral sequential lung transplantations were performed in Shanghai Chest Hospital.In 2 cases,the resection and re-transplantation of the second lung was done after ventilation and perfusion in the first lung transplantation.In 6 cases,after the first lung was transplanted,ECMO was established with heparin-bonded circuitry and centrifugal pump and the second lung was transplanted.In 1 case,CPB was used during the transplantation of the second lung.Meanwhile,inhaled nitric oxide(INO) therapy(40 ppm) was performed in 7 cases.Results Severe lung edema occurred in 2 cases,and the patients survived only 12 and 36 h respectively.Six cases with ECMO thereafter rided out the operation successfully.Postoperative days ventilated were 36 to 72 h(mean 48 h).Four patients of them discharged in good conditions and have survived 16,14,11,9 months respectively.One patient died of pulmonary infection and emptysis one month after operation.Another patient died of acute renal failure 3 weeks after operation.The operation performed under the support of CPB was unsuccessful because of heavy hemorrhage and severe acidosis.Conclusions Bilateral sequential lung transplantation is a high risk procedure.ECMO can reduce the risk significantly. Inhaled nitric oxide during and after operation is of benefit to stabilization of hemodynamics and reduce ischemic reperfusion injury.
