在一名伴有复杂泵袋感染的高敏患者中成功实现移植过渡。
Successful bridge to transplant in a highly sensitized patient with a complicated pump pocket infection.
作者信息
McGee Edwin C, Cotts William, Tambur Anat R, Friedewald John, Kim John, O'Connell John, Wallace Suzanne, McCarthy Patrick M
机构信息
Division of Cardiothoracic Surgery, Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, 201 East Huron Street, Galter 11-140, Chicago, IL 60611, USA.
出版信息
J Heart Lung Transplant. 2008 May;27(5):568-71. doi: 10.1016/j.healun.2008.02.006.
A 32-year-old man with doxorubicin-induced cardiomyopathy presented in cardiogenic shock. He underwent placement of a Novacor (WorldHeart, Inc., Oakland, CA) left ventricular assist device as a bridge to transplant. Post-operatively he developed a pump pocket infection and dehiscence of his abdominal wound with exposure of the pump. This was treated with irrigation and drainage, antibiotic bead placement and flap closure. Both pre- and post-operative panel-reactive antibodies (PRA) were elevated. He underwent desensitization with intravenous immune globulin (IVIg), rituximab, mycophenolate mofetil and pre-operative plasmapheresis. A donor heart was identified and found to be acceptable by virtual crossmatch. He was transplanted and is doing well with normal graft function at >1 year post-operatively.
一名32岁患有阿霉素诱导性心肌病的男子出现心源性休克。他接受了诺瓦科尔（世界心脏公司，加利福尼亚州奥克兰）左心室辅助装置植入作为移植桥梁。术后他发生了泵袋感染和腹部伤口裂开，泵外露。对此进行了冲洗引流、抗生素珠植入和皮瓣闭合治疗。术前和术后群体反应性抗体（PRA）均升高。他接受了静脉注射免疫球蛋白（IVIg）、利妥昔单抗、霉酚酸酯和术前血浆置换脱敏治疗。确定了一名供体心脏，经虚拟交叉配型发现可接受。他接受了移植，术后1年多来移植心脏功能正常，情况良好。
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