Landolt Luke, Goldstein Joseph C, Weir William, Rackauskas Mindaugas, AbuRahma Joseph
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA.
Department of Anesthesiology, North Florida/South Georgia Veterans Health System and University of Florida College of Medicine, Gainesville, FL, USA.
Ann Card Anaesth. 2025 Jul 1;28(3):325-328. doi: 10.4103/aca.aca_11_25. Epub 2025 Jul 8.
Sensitized lung transplantation recipients are at an increased risk for complications. Therapies such as plasma exchange (PLEX) exist to lessen the antibody burden in hopes of mitigating acute and chronic complications. Although the use of PLEX has been shown to be an effective immunomodulation for many diseases, its benefit in lung transplantation has been debated, and the fear of PLEX-induced coagulopathy has curtailed its use more broadly. Although the type of fluid used for exchange can determine the severity of coagulopathy, even the use of fresh frozen plasma (FFP) can disrupt the coagulation cascade. We present the case of severe perioperative coagulopathy following PLEX with FFP during bilateral lung transplantation.
致敏的肺移植受者发生并发症的风险增加。诸如血浆置换（PLEX）之类的疗法旨在减轻抗体负担，以期减轻急性和慢性并发症。尽管已证明PLEX的使用对许多疾病是一种有效的免疫调节方法，但其在肺移植中的益处一直存在争议，而且对PLEX诱导的凝血病的担忧限制了其更广泛的应用。尽管用于置换的液体类型可决定凝血病的严重程度，但即使使用新鲜冷冻血浆（FFP）也会破坏凝血级联反应。我们报告了一例在双侧肺移植期间使用FFP进行PLEX后发生严重围手术期凝血病的病例。
