Department of Anaesthesiology, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Med J. 2011 Mar;52(3):e48-51.
We report a case of combined heart and liver transplantation for familial amyloid polyneuropathy. This is the first such combined transplant performed in Asia, and differs from previously described cases, in that cardiopulmonary bypass was continued at partial flow during liver transplantation in our case. This was done in order to provide haemodynamic support to the cardiac graft and to protect it from the impending reperfusion insult that frequently accompanies liver transplantation. The utility of this management course is discussed, along with its actual and potential complications. We also describe the impact of a lung-protective ventilation strategy employed during cardiac transplantation.
我们报告了一例家族性淀粉样多神经病的心脏和肝脏联合移植。这是亚洲首例此类联合移植，与之前描述的病例不同，我们的病例在肝移植过程中继续以部分流量进行心肺转流。这样做是为了向心脏移植物提供血液动力学支持，并保护其免受肝移植时经常伴随的再灌注损伤。讨论了这种管理方案的实用性，及其实际和潜在的并发症。我们还描述了在心脏移植过程中使用的肺保护通气策略的影响。
