Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2014 Jun;66(6):467-71. doi: 10.4097/kjae.2014.66.6.467. Epub 2014 Jun 26.
Multivisceral organ transplantation involves the transplantation of three or more abdominal organs, including small bowel, duodenum, stomach, liver, pancreas, colon, and so on. The large amounts of cold and acidic loading into systemic circulation from the graft during multivisceral organ transplantation may result in severe post-reperfusion syndrome (PRS). We describe here a 6-year-old pediatric patient with chronic intestinal pseudo-obstruction who experienced prolonged PRS and severe metabolic acidosis during seven abdominal organ transplantation including the liver, spleen, stomach, duodenum, small bowel, colon and pancreas. The hypotensive period lasted approximately 10 minutes after graft reperfusion and was accompanied by severe metabolic acidosis and hypothermia. Since PRS can be easily associated with adverse outcomes, such as poor early graft function and primary non-function, not only meticulous surveillance for aggravating factors for PRS but also their immediate correction were necessary in managing a pediatric patient undergoing multivisceral organ transplantation.
多器官联合移植涉及三个或更多腹部器官的移植，包括小肠、十二指肠、胃、肝、胰腺、结肠等。多器官联合移植过程中，移植器官大量冷、酸性物质进入体循环可能导致严重的再灌注后综合征（PRS）。我们在此描述了一例 6 岁慢性肠假性梗阻患儿，在 7 个腹部器官移植（包括肝、脾、胃、十二指肠、小肠、结肠和胰腺）中经历了长时间的 PRS 和严重的代谢性酸中毒。再灌注后，低血压期持续约 10 分钟，同时伴有严重的代谢性酸中毒和低体温。由于 PRS 很容易导致不良后果，如早期移植物功能不良和原发性无功能，因此在管理接受多器官联合移植的儿科患者时，不仅需要密切监测 PRS 的加重因素，还需要立即纠正这些因素。
