Oishi Hisashi, Okada Yoshinori, Saiki Yoshikatsu, Sado Tetsu, Noda Masafumi, Hoshikawa Yasushi, Endo Chiaki, Sakurada Akira, Maeda Sumiko, Akiba Miki, Hoshi Kunihiko, Kondo Takashi
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi Aoba-ku, Sendai, 980-8575, Japan.
Surg Today. 2015 May;45(5):630-3. doi: 10.1007/s00595-014-0931-3. Epub 2014 May 20.
We report a case of bilateral lung transplantation (BLT) after preservation of the donor graft for 16 h 5 min with EP-TU, an extracellular phosphate-buffered lung preservation solution. The recipient was a 26-year-old woman with idiopathic pulmonary arterial hypertension and the graft ischemic time was prolonged significantly because of the time required to induce peripheral veno-arterial extracorporeal membrane oxygenation (V-A ECMO) under local anesthesia, and address the severe intrathoracic and pericardial adhesions from past surgery for partial anomalous pulmonary venous return, with concurrent annular plication of the tricuspid valve. After the operation, ECMO and continuous hemodiafiltration were started preemptively to protect the grafts against excessive edema. Postoperative chest X-ray showed diffuse bilateral infiltrates, which improved within a few days and she was weaned off ECMO on day 9. Successful BLT after a graft ischemic time of over 16 h has rarely been described in clinical lung transplantation.
