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イチバ シンゴ
Ichiba Shingo
市場 晋吾 所属 医学部 医学科（東京女子医科大学病院） 職種 教授 |
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| 論文種別 | 症例報告 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Lung transplant after long-term veno-venous extracorporeal membrane oxygenation: a case report. |
| 掲載誌名 | 正式名：Journal of cardiothoracic surgery 略 称：J Cardiothorac Surg ISSNコード：17498090/17498090 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 16(1),pp.246 |
| 著者・共著者 | Yoshiyasu Nobuyuki, Sato Masaaki, Anraku Masaki, Ichiba Shingo, Nakajima Jun |
| 発行年月 | 2021/08 |
| 概要 | BACKGROUND:Although the number of patients who undergo extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation is increasing worldwide, there are few reports on lung transplantation after long-term ECMO (more than 1 month). We report a rare case of successful bilateral lung transplantation in a Japanese patient after 5 months of veno-venous (VV)-ECMO support.CASE PRESENTATION:A 27-year-old man who underwent bone marrow transplantation (BMTx) with fully matched human leukocyte antigen typing was diagnosed with bronchiolitis obliterans caused by chronic graft-versus-host disease 3 years after the BMTx. One year later, his respiratory condition had exacerbated, with carbon dioxide retention that required conventional mechanical ventilation. He was then deemed a suitable candidate for lung transplantation by a multidisciplinary transplantation selection committee. While waiting for donor lungs, his hypercapnia and acidosis became barely manageable under care with mechanical ventilation and ultimately he was switched to VV-ECMO. He remained on VV-ECMO for the next 5 months, during which period the circuit was switched nine times. In addition, sophisticated intensive care was required to manage multiple episodes of sepsis and coagulopathy. A suitable donor was identified 5 months later, and bilateral lung transplantation was initiated with continuous VV-ECMO. The procedure itself was extremely challenging owing to severe adhesions resulting from previous thoracotomy, inflammation, infection, and intrapulmonary hemorrhage. The operative time for the transplantation was about 19 h. Currently, at 2 years 8 months postoperatively, the patient is alive and well.CONCLUSION:Transplant surgery in this patient was extremely challenging because of the presence of severe pleural adhesions and stiff native lungs secondary to hemorrhagic complications due to the prolonged ECMO support. Surgeons must recognize that lung transplantation after long-term ECMO bridgi |
| DOI | 10.1186/s13019-021-01614-8 |
| PMID | 34461945 |