J Formos Med Assoc. 1992 Sep;91(9):926-32.
After successful animal studies since 1986, a single left lung transplantation was performed on a 35-year-old male patient with end-stage silicosis in July 1991. The surgical technique was similar to that used by the Toronto Transplant Group, except for some modification in bronchial anastomosis. The donor lung was preserved by simple surface cooling after the administration of heparin, methylprednisolone and PGE1. The ischemic time for the donor lung was 3.5 hours. A cardiopulmonary bypass through the femoral vessels was applied for a duration of 90 minutes. Immediate postoperative complications included massive bleeding, disseminated intravascular coagulation, adult respiratory distress syndrome and acute graft rejection. Fortunately, we overcame these complications through intensive care. Immunosuppression included antilymphocytic globulin, cyclosporine, azathioprine and corticosteroids. The results of this single lung transplantation were satisfactory. The patient was doing well and was able to satisfactorily breathe room air six weeks after the transplantation. Unfortunately, the patient died of opportunistic systemic aspergillosis six months after the transplantation. In conclusion, lung transplantation is an effective treatment for patients with end-stage lung diseases, and the results of this first single lung transplantation in Taiwan are encouraging and promising.
自1986年动物实验取得成功后，1991年7月为一名35岁晚期矽肺男性患者实施了单肺移植手术。手术技术与多伦多移植小组所采用的相似，但支气管吻合术稍有改动。在给予肝素、甲基强的松龙和前列腺素E1后，供肺通过简单的表面降温进行保存。供肺缺血时间为3.5小时。通过股血管进行体外循环90分钟。术后即刻并发症包括大量出血、弥散性血管内凝血、成人呼吸窘迫综合征和急性移植物排斥反应。幸运的是，我们通过重症监护克服了这些并发症。免疫抑制包括抗淋巴细胞球蛋白、环孢素、硫唑嘌呤和皮质类固醇。此次单肺移植的结果令人满意。患者情况良好，移植后六周能够满意地呼吸室内空气。不幸的是，患者在移植后六个月死于机会性全身曲霉菌病。总之，肺移植是终末期肺部疾病患者的有效治疗方法，台湾首例单肺移植的结果令人鼓舞且前景乐观。
