First human transplantation of a nonacceptable donor lung after reconditioning ex vivo
First human transplantation of a nonacceptable donor lung after reconditioning ex vivo
复制标题
DOI：
10.1016/j.athoracsur.2007.01.033
复制
发表时间：
2007-06-01
影响因子：
4.6
通讯作者：
Sjoberg, Trygve
中科院分区：
文献类型：
--
作者：
Steen, Stig;Ingemansson, Richard;Sjoberg, Trygve
目的。本文描述了一种体外修复和移植排斥供体肺的方法。一名19岁的男子在一次交通事故中脑死亡。x线片显示双侧肺挫伤。他有持续的气管内出血。优化呼吸机治疗并吸气管后，PaO2在FiO(2) = 0.7时为9 kPa （67.5 mm Hg）。这些肺在北欧国家的所有移植中心都被排斥。我们采集肺部用于研究。右肺严重受伤。左肺水肿，下肺叶有出血点，中基底段不张。左肺在体外修复并保持局部体外膜氧合，直到17小时后移植到一位患有慢性阻塞性肺病的70岁男性。移植的肺功能很好，病人恢复得很顺利。在3个月的对照时，胸部计算机断层扫描和经支气管活检显示左肺正常，患者的临床状况非常好，只是在移植后11个月死于无关事件。被排斥的供体肺可以在体外修复后成功移植。
Purpose. This article describes an ex vivo method to recondition and transplant rejected donor lungs.Description. A 19-year-old man was brain dead after a traffic accident. A roentgenogram showed bilateral lung contusion. He had ongoing intratracheal bleeding. After optimizing ventilator treatment and suctioning the airways, PaO2 was 9 kPa (67.5 mm Hg) on FiO(2) = 0.7. The lungs were rejected by all transplantation centers in the Nordic countries. We harvested the lungs for research. The right lung was severely injured. The left lung was edematous with bleeding spots in the lower lobe, and the mediobasal segment was atelectatic. The left lung was reconditioned ex vivo and kept in topical extracorporeal membrane oxygenation until it was transplanted into a 70-year-old man with chronic obstructive pulmonary disease 17 hours later.Evaluation. The transplanted lung functioned very well, and the patient recovered uneventfully. At 3 months control, a computed tomographic thoracic scan and transbronchial biopsies showed a normal left lung, and the patient was in very good clinical condition, only to succumb to death from unrelated events 11 months after the transplantation.Conclusions. Rejected donor lungs may be successfully transplanted after being reconditioned ex vivo.