A staged approach for a lung-liver transplant patient using ex vivo reconditioned lungs first followed by an urgent liver transplantation.

Autor: Van De Wauwer C; Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., Verschuuren EA, Nossent GD, van der Bij W, den Hamer IJ, Klinkenberg TJ, van den Berg AP, de Boer MT, Mariani MA, Erasmus ME
Jazyk: angličtina
Zdroj: Transplant international : official journal of the European Society for Organ Transplantation [Transpl Int] 2015 Jan; Vol. 28 (1), pp. 129-33. Date of Electronic Publication: 2014 Aug 29.
DOI: 10.1111/tri.12408
Abstrakt: Combined lung-liver transplantation is a logistically challenging procedure hampered by shortage of organ donors. We describe the case of a young patient with end-stage lung disease due to of cystic fibrosis and liver cirrhosis who needed combined lung-liver transplantation. The long waiting for this caused an interesting clinical dilemma. We decided to change our policy in this situation by listing him only for the lung transplantation and to apply for a high urgent liver transplantation if the liver failed after the lung transplantation. This strategy enabled us to use lungs treated with ex vivo lung perfusion (EVLP) from an unsuitable donor after circulatory death. After conditioning for 4 h via EVLP, the pO2 was 59.7 kPa. The lungs were transplanted successfully. He developed an acute-on-chronic liver failure for which he received a successful liver transplantation 19 days after the lung transplantation.
(© 2014 Steunstichting ESOT.)
Databáze: MEDLINE
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