Implantation of the liver during reperfusion of the heart in combined heart-liver transplantation: own experience and review of the literature.

Autor: Rauchfuss F; Department of General, Visceral and Vascular Surgery, Friedrich-Schiller-University Jena, Jena, Germany. Falk.Rauchfuss@med.uni-jena.de, Breuer M, Dittmar Y, Heise M, Bossert T, Hekmat K, Settmacher U
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2011 Sep; Vol. 43 (7), pp. 2707-13.
DOI: 10.1016/j.transproceed.2011.04.010
Abstrakt: Background: There are only a few reports about combined heart-liver transplantations. The surgical techniques differ widely, ranging from sequential implantation of the organs to simultaneous transplantations. We report our experience with simultaneous, combined heart-liver transplantations without using a veno-venous bypass demonstrating that this is a feasible surgical technique.
Methods: Since 2005, we performed 4 combined heart-liver transplantations by implanting the liver during the reperfusion period of the newly implanted heart. We retrospectively reviewed patient clinical data and outcomes.
Results: The mean operative time was 534 ± 247 minutes and the ischemia times for heart and liver were 190 ± 72 minutes (cold ischemia time for the heart), 98 ± 96 minutes (warm ischemia time for the heart), 349 ± 101 minutes (cold ischemia time for the liver), and 36.25 ± 3.5 minutes (warm ischemia time for the liver). Three patients were discharged from the hospital after an uneventful clinical course. One patient died due to multi-organ failure during the intensive care unit stay on the 23rd postoperative day.
Conclusion: We suggest that combined, simultaneous heart-liver transplantation without veno-venous bypass is a feasible surgical technique.
(Copyright © 2011 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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