采用选择性体外循环进行肺移植后的结果：单中心经验
Outcomes after lung transplantation performed using elective cardiopulmonary bypass: A single-center experience.
作者信息
Blanding Walker M, Hill Morgan A, Hashmi Z A, Huang Kevin X, Whelan Timothy P M, Paoletti Luca, Engelhardt Kathryn E, Gibney Barry C
机构信息
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
出版信息
JHLT Open. 2024 Apr 1;4:100089. doi: 10.1016/j.jhlto.2024.100089. eCollection 2024 May.
BACKGROUND
There remains significant variability in the use of intraoperative mechanical circulatory support in lung transplantation. This report details our outcomes using elective cardiopulmonary bypass (CPB) in lung transplantation.
METHODS
We performed a single institution analysis of consecutively enrolled patients who underwent isolated lung transplantation between August 2020 and April 2023. Primary outcomes included rates of grade 3 primary graft dysfunction (PGD) and 1-year survival.
RESULTS
Forty consecutive lung transplants were performed on CBP over the study period. The average PaO/FiO at 72 hours was 369.7 ± 121.4, with grade 3 PGD occurring in 2 patients (5%). The median intraoperative packed red blood cell transfusion requirement was 300 (93.75-727.5) ml. Freedom from nonelective reoperation was 82.5% ( = 33). Mortality was 0% at 90 days, and 1-year survival was 90.5%.
CONCLUSIONS
Lung transplantation can be safely performed with elective CPB support.
背景
肺移植术中机械循环支持的使用仍存在显著差异。本报告详细介绍了我们在肺移植中使用选择性体外循环（CPB）的结果。
方法
我们对2020年8月至2023年4月期间连续登记的接受单肺移植的患者进行了单机构分析。主要结局包括3级原发性移植功能障碍（PGD）的发生率和1年生存率。
结果
在研究期间，连续对40例患者进行了CPB下的肺移植。72小时时的平均PaO/FiO为369.7±121.4，2例患者（5%）发生3级PGD。术中红细胞悬液输注量的中位数为300（93.75 - 727.5）ml。非选择性再次手术的无事件生存率为82.5%（n = 33）。90天时死亡率为0%，1年生存率为90.5%。
结论
在选择性CPB支持下可安全地进行肺移植。
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