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活体肝移植后的体外膜肺氧合

Extracorporeal membrane oxygenation after living-related liver transplant.

作者信息

Gedik Ender, Çelik Muhammet Reha, Otan Emrah, Dişli Olcay Murat, Erdil Nevzat, Bayındır Yaşar, Kutlu Ramazan, Yılmaz Sezai

机构信息

From the Department of Anesthesiology and Reanimation, Baskent University Faculty of Medicine, Ankara, Turkey.

出版信息

Exp Clin Transplant. 2015 Apr;13 Suppl 1:290-3. doi: 10.6002/ect.mesot2014.p136.

Abstract

Various types of extracorporeal membrane oxygenation methods have been used in liver transplant operations. The main indications are portopulmonary or hepatopulmonary syndromes and other cardiorespiratory failure syndromes that are refractory to conventional therapy. There is little literature available about extracorporeal membrane oxygenation, especially after liver transplant. We describe our experience with 2 patients who had living-related liver transplant. A 69-year-old woman had refractory aspergillosis pneumonia and underwent pumpless extracorporeal lung assist therapy 4 weeks after liver transplant. An 8-month-old boy with biliary atresia underwent urgent liver transplant; he received venoarterial extracorporeal membrane oxygenation therapy on postoperative day 1. Despite our unsuccessful experience with 2 patients, extracorporeal membrane oxygenation and pumpless extracorporeal lung assist therapy for liver transplant patients may improve prognosis in selected cases.

摘要

各种类型的体外膜肺氧合方法已用于肝移植手术。主要适应症是肝肺综合征或肝肺综合征以及其他对传统治疗无效的心肺衰竭综合征。关于体外膜肺氧合的文献很少,尤其是在肝移植后。我们描述了2例亲属活体肝移植患者的经验。一名69岁女性患有难治性曲霉菌肺炎,在肝移植后4周接受了无泵体外肺辅助治疗。一名8个月大的胆道闭锁男孩接受了紧急肝移植;他在术后第1天接受了静脉-动脉体外膜肺氧合治疗。尽管我们对2例患者的治疗经验并不成功,但对于肝移植患者,体外膜肺氧合和无泵体外肺辅助治疗在某些特定情况下可能会改善预后。

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