Balik, Martin and Rulisek, Jan and Flaksa, Marek and Porizka, Michal and Mosna, Frantisek and Lindner, Jaroslav and Heller, Samuel and Belohlavek, Jan and Adla, Theodor and Schmid, Christof and Philipp, Alois and Havlin, Jan and Burkert, Jan and Lischke, Robert (2022) A patient with pulmonary hypertension waiting for donor lungs during the pandemic: 194 days on extracorporeal life support including 143 days on pulmonary artery to left atrium shunt. AMERICAN JOURNAL OF TRANSPLANTATION, 22 (8). pp. 2094-2098. ISSN 1600-6135, 1600-6143
Full text not available from this repository. (Request a copy)Abstract
Patients with pulmonary hypertension and end-stage lung disease are fraught with high mortality while on a waiting list for lung transplant. With sometimes rapid deterioration they may require veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as an immediate life-saving technique, which is a time-limited solution. The technique of pulmonary artery to left atrium (PA-LA) shunt fitted with an oxygenator enables bridging the patient to transplant for a longer time period. This low-resistance paracorporeal pumpless lung assist device allows for de-adaptation of the right ventricle back to lower afterload before the lung transplantation is carried out. The PA-LA shunt with an oxygenator also conveys a risk of multiple complications with reported median of 10-26 days until transplant. We report a case of pulmonary capillary hemangiomatosis in a 35-year-old female who had to wait for donor lungs during the pandemic of SARS-CoV-2 for 143 days on PA-LA shunt with oxygenator following 51 days on VA-ECMO. The extremely long course associated with multiple complications including three cerebral embolisms, episodes of sepsis and ingrowth of the return cannula into the left ventricular wall gives insight into the limits of this bridging technique.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRANSPLANTATION; BRIDGE; NOVALUNG; bridge to transplant; extracorporeal membrane oxygenation; lung transplant; pulmonary hypertension; right heart failure; SARS-CoV-2 pandemic |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Feb 2024 07:24 |
| Last Modified: | 01 Feb 2024 07:24 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58511 |
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