Division of Cardiothoracic Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Am J Transplant. 2022 Jan;22(1):294-298. doi: 10.1111/ajt.16806. Epub 2021 Sep 7.
Lung transplantation with lungs procured from donors after circulatory death (DCD) has been established as an alternative technique to traditional donation after brain death (DBD) with comparable outcomes. Recently, in situ thoracoabdominal normothermic regional perfusion (TA-NRP) has emerged as a novel technique employed in the procurement of cardiac allografts after circulatory death. TA-NRP, in contrast to ex situ machine perfusion, has the advantage of allowing in situ assessment of donor organs prior to final acceptance. However, there are some concerns that this technique may adversely impact the quality of lung allografts. Here, we present a case of a successful bilateral sequential lung transplantation in a patient with postinflammatory pulmonary fibrosis due to acute respiratory distress syndrome (ARDS), with lungs procured after normothermic in situ lung perfusion. Apart from the lungs, heart, liver, and kidneys were also successfully transplanted from this donor.
肺移植采用来自循环死亡（DCD）供体的肺已被确立为传统脑死亡（DBD）供体后移植的替代技术，具有可比的结果。最近，原位胸腹常温区域灌注（TA-NRP）已成为一种新的技术，用于获取循环死亡后的心脏同种异体移植物。与离体机器灌注相比，TA-NRP 的优点是可以在最终接受之前原位评估供体器官。然而，有人担心该技术可能会对肺移植物的质量产生不利影响。在这里，我们报告了一例成功的双侧序贯肺移植病例，该患者因急性呼吸窘迫综合征（ARDS）引起的炎症后肺纤维化，采用常温原位肺灌注获取肺。除了肺，心脏、肝脏和肾脏也成功地从该供体移植。
