Extracorporeal circulatory support for lung transplantation: institutional experience
| Autor: | T. De Giacomo, Marco Anile, V. Liparulo, Franco Ruberto, Federico Francioni, G. F. Coloni, C. Ricella, Daniele Diso, Erino A. Rendina, Francesco Pugliese, Federico Venuta, M. Rolla, Emanuele Russo |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Lung Diseases
medicine.medical_specialty Cystic Fibrosis medicine.medical_treatment Hypertension Pulmonary Pulmonary Fibrosis Lithiasis Risk Assessment law.invention Intraoperative Period Pulmonary Disease Chronic Obstructive law Internal medicine medicine.artery Cardiopulmonary bypass Medicine Lung transplantation Humans Cause of death Transplantation Lung Bronchiectasis Cardiopulmonary Bypass business.industry medicine.disease Pulmonary hypertension Survival Rate medicine.anatomical_structure Pulmonary artery Cardiology Surgery business Lung Transplantation |
| Popis: | Lung transplantation (LT) represents the only available therapy for selected patients affected by end-stage pulmonary disease. Cardiopulmonary bypass (CPBP) is used, when required, during single and sequential double lung transplantation; however, it increases the risk of bleeding, early graft dysfunction, failure, and other potential side effects. We report our experience with 145 patients who underwent lung transplantations, among whom 34 required intraoperative CPBP. The indications for LT among these 34 patients were cystic fibrosis (n = 22), chronic obstructive pulmonary disease (n = 3), bronchiectasis (n = 2), primary pulmonary hypertension (n = 1), fibrosis (n = 2), pulmonary microlithiasis (n = 1), and retransplantation for obliterative bronchilitis (n = 3). CPBP was planned in 12 cases (group I) and unplanned in 22 (group II). The main reason for planning CPBP was primary and secondary pulmonary hypertension (mean pulmonary artery pressureor=25 mm Hg). Acute right ventricular failure, hemodynamic instability, arterial desaturation, and increased pulmonary artery pressure were mandatory for unplanned CPBP. Among the 34 CPBP patients, the 30-day mortality rate was 35% (12/34) including 9 (70%) in group II (unplanned CPBP). The leading cause of death was multiorgan failure. The 1-year survival rates were 67% and 36%, and the 3-year survival rates were 47% and 18% for groups I and II, respectively. In conclusion, even if it represents a useful tool in the management of critical events, the use of unscheduled CPBP during LT procedures is associated with an increased postoperative morbidity and mortality. |
| Databáze: | OpenAIRE |
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