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一例既往对侧全肺切除的囊性纤维化患者行肺肝联合移植:病例报告。

Combined Single Lung and Liver Transplantation in a Cystic Fibrosis Patient With Previous Contralateral Pneumonectomy: A Case Report.

机构信息

Department of Thoracic Surgery and Lung Transplantation, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.

Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix Rousse University Hospital, Claude-Bernard Lyon 1 University, Lyon, France.

出版信息

Transplant Proc. 2020 Nov;52(9):2820-2823. doi: 10.1016/j.transproceed.2020.08.036. Epub 2020 Oct 1.

Abstract

Combined lung-liver transplantation is a rare life-saving procedure to treat concomitant end-stage lung and liver failure. In this report, we describe the first published case of single lung and liver transplantation in a cystic fibrosis patient who had previously undergone a pneumonectomy for the treatment of an infected and destroyed right lung. We detail the lung first, sequential transplant procedure and surgical difficulties due to mediastinal shift. Emergent intraoperative renal replacement therapy was carried out before liver transplantation to overcome pulmonary edema in the transplanted lung. After fluid balance equilibration, liver transplantation was performed in good conditions. The patient is currently alive with no signs of rejection 8 years after the procedure.

摘要

肺肝联合移植是一种罕见的挽救生命的手术,用于治疗同时患有终末期肺和肝衰竭的患者。在本报告中,我们描述了首例囊性纤维化患者进行单肺和肝联合移植的病例,该患者曾因感染和破坏的右肺而行肺切除术。我们详细描述了由于纵隔移位而导致的肺第一、序贯移植程序和手术困难。在进行肝移植之前,进行了紧急术中肾脏替代治疗,以克服移植肺中的肺水肿。在液体平衡平衡后,在良好的条件下进行了肝移植。该患者在手术后 8 年,目前仍存活且无排斥迹象。

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