Schiavon Marco, Calabrese Francesca, Di Gregorio Guido, Loy Monica, Marulli Giuseppe, Rebusso Alessandro, Calabrese Fiorella, Rea Federico
Department of Cardiac, Thoracic and Vascular Sciences, Thoracic Surgery Division, University of Padova, Via Giustiniani 2, 35100, Padova, Italy.
Department of Anaesthesiology and Intensive Care, University-Hospital of Padova, via Giustiniani 2, 35100, Padova, Italy.
J Cardiothorac Surg. 2017 May 18;12(1):30. doi: 10.1186/s13019-017-0597-1.
Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval.
Our case presents a successful procurement and bilateral lung transplantation from a donor supported by a left ventricular assist device (LVAD) who experienced an intraoperatively haemodynamic complication. The use of portable normothermic perfusion device let us to reduce ischemic injury and assess these marginal donor lungs helping us to determine the clinical suitability for transplantation. Given our extensive experience with the device instrumentation and management, the EVLP process was uneventful with excellent post-transplant course.
This case report demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system using the portable normothermic perfusion platform to assess and preserve these donor lungs.
肺移植（LTx）受限于合适供体的短缺。为克服这一问题，许多项目已开始使用扩大标准供体（边缘供体）。然而，植入机械循环支持系统的脑死亡患者很少被视为潜在的肺供体。本病例证明了尽管肺获取可能存在困难，但从机械循环支持系统支持的器官供体进行肺移植的可行性。
我们的病例展示了从一名由左心室辅助装置（LVAD）支持的供体成功获取并进行双侧肺移植，该供体术中出现血流动力学并发症。便携式常温灌注装置的使用使我们能够减少缺血性损伤，并评估这些边缘供体肺，帮助我们确定移植的临床适用性。鉴于我们在该装置仪器和管理方面的丰富经验，体外肺灌注（EVLP）过程顺利，移植后病程良好。
本病例报告证明了使用便携式常温灌注平台评估和保存这些供体肺，从机械循环支持系统支持的器官供体进行肺移植的可行性。
