Moreno Casado P, Alvarez Kindelán A, Algar Algar F J, Espinosa Jiménez D, Cano García J R, Cerezo Madueño F, Baamonde Laborda C, López Cillero P, Salvatierra Velázquez A
Thoracic Surgery and Lung Transplantation Unit, University Hospital Reina Sofía, Córdoba, Spain.
Transplant Proc. 2008 Nov;40(9):3126-7. doi: 10.1016/j.transproceed.2008.08.100.
To analyze the results of combined lung and liver transplantation.
We performed two combined lung and liver transplantations for patients with cystic fibrosis with chronic respiratory failure accompanied by advanced liver disease. In each case, all thoracic and abdominal organs were obtained from a single donor by means of standard harvest techniques. In the recipient, a two-stage procedure was adopted with completion of the bilateral lung transplantation before the liver operation. Immunosuppression consisted of three-drug therapy used for isolated lung transplantation.
The patients were both boys of 13 and 15 years old. Episodes of acute pulmonary rejection were successfully treated with intravenous steroids. Neither lung disorder was associated with a liver rejection episode. Airway complications that occurred in both cases were managed endoscopically.
Combined transplantation of lung and liver is a feasible and therapeutically effective procedure for patients with cystic fibrosis complicated by advanced liver disease. Herein we have described our experience in two of the only three cases of combined liver and lung transplantation performed in Spain to date. Patient and graft survivals were comparable to isolated liver or isolated bilateral lung transplantations.
分析肺肝联合移植的结果。
我们对两名患有囊性纤维化且伴有慢性呼吸衰竭及晚期肝病的患者进行了肺肝联合移植。在每例手术中，所有胸腹部器官均通过标准获取技术从单一供体获取。在受体中，采用两阶段手术，在肝脏手术前完成双侧肺移植。免疫抑制采用用于单纯肺移植的三联药物疗法。
两名患者均为13岁和15岁的男孩。急性肺排斥反应发作通过静脉注射类固醇成功治疗。肺部疾病均未与肝排斥反应发作相关。两例均发生的气道并发症通过内镜处理。
对于合并晚期肝病的囊性纤维化患者，肺肝联合移植是一种可行且治疗有效的手术。在此我们描述了我们在西班牙迄今为止仅有的三例肺肝联合移植中的两例的经验。患者和移植物存活率与单纯肝移植或单纯双侧肺移植相当。
