Abstract:
:Cardiopulmonary bypass (CPB) is required in some lung transplantation (LTx) operations. However, it increases risks of bleeding and early graft dysfunction. We report our experiences of replacing CPB with heparin-bound extracorporeal membrane oxygenation (ECMO) in LTx operations. If extracorporeal circulation was anticipated for the LTx operations, ECMO support was set up through the femoral venoarterial route after induction of anesthesia; then, LTx was done as usual. Five thousand units of heparin was injected intravenously during the femoral vessels cannulation, but no more was used during the first 24 h of ECMO support. If necessary, as in patients undergoing single LTx for end-stage pulmonary hypertension, the ECMO support was directly extended into the postoperative period until reperfusion edema of the graft lung subsided. Twelve single LTxs and 3 bilateral sequential single LTxs were done under ECMO support. The advantages of using femoral ECMO rather than conventional CPB in LTx operations were the operative field was not disturbed by the bypass cannula, stable cardiopulmonary function and normothermia were maintained throughout the operations, there were less blood loss and transfusion requirements, and the left LTx was as easily performed as the right LTx. Red blood cell transfusion requirements during the operation and the first postoperative day were 4.4 +/- 2.8 and 2.4 +/- 2.0 U, respectively, in 10 adult patients undergoing uncomplicated single LTx with ECMO support, and 4.3 +/- 1.3 and 1.5 +/- 1.5 U in 8 adult patients undergoing single LTx without any extracorporeal circulatory support. The difference was not significant between the 2 groups (p = 0.53 and 0.32 by Mann-Whitney U test). The ECMO did not increase blood transfusion requirements. In comparison, 13 U of red blood cell transfusion was required in 2 patients receiving single LTx under CPB support. The ECMO support made the postoperative critical care easier in recipients with graft lung edema. Except for 2 cases of primary graft failure, the ECMO could be weaned off and removed at bedside within a short period (27.9 +/- 24.6 h, n = 13) with no major complications. In conclusion, the heparin-bound femoral ECMO rather than CPB should be used for LTx operations unless concomitant cardiac repair is planned.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Ko WJ,Chen YS,Lee YCdoi
10.1046/j.1525-1594.2001.025008607.xsubject
Has Abstractpub_date
2001-08-01 00:00:00pages
607-12issue
8eissn
0160-564Xissn
1525-1594pii
aor6808journal_volume
25pub_type
杂志文章abstract::Therapeutic means to lower Lp(a) are limited. The most effective method to reduce plasma Lp(a) concentration significantly is therapeutic apheresis, namely, low-density lipoprotein (LDL) lipoprotein(a) (Lp(a)) apheresis. A novel technique based on reusable LDL adsorber called Lipocollect 200 (Medicollect, Rimbach, Ger...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00959.x
更新日期:2009-12-01 00:00:00
abstract::Our aim was to study the aging effects on the in vitro biological properties of bone marrow-derived mesenchymal stem cells (BMSCs) for construction of tissue-engineered heart valves. BMSCs were taken from teenagers with congenital heart diseases, and middle-aged and elderly patients with valvular diseases. Proliferati...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00824.x
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abstract::Left ventricle (LV) unloading caused by a left ventricular assist device (LVAD) has been shown to enhance reverse LV remodeling in end-stage cardiomyopathy. Several reports consistently suggest that a pulsatile-flow LVAD has more profound effects compared to continuous-flow LVAD, though the responsible mechanisms are ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13348
更新日期:2019-04-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12814
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abstract::The new Advanced ventricular assist device (Advanced VAD) has many features such as improving pulsatility and preventing regurgitant flow during pump stoppage. The purpose of this study was to evaluate the effects of design modifications of the Advanced VAD on these features in vitro. Bench testing of four versions of...
journal_title:Artificial organs
pub_type: 杂志文章
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2011.01328.x
更新日期:2012-03-01 00:00:00
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journal_title:Artificial organs
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journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:2011-12-01 00:00:00
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journal_title:Artificial organs
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1999.06258.x
更新日期:1999-04-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb03303.x
更新日期:1994-01-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2005.29022.x
更新日期:2005-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章,meta分析
doi:10.1111/aor.13378
更新日期:2019-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13616
更新日期:2020-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2004.29012.x
更新日期:2005-01-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1996.tb04418.x
更新日期:1996-01-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1978.tb03442.x
更新日期:1978-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1999.06228.x
更新日期:1999-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13507
更新日期:2019-11-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.06127.x
更新日期:1998-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12294
更新日期:2014-12-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2000.06591.x
更新日期:2000-08-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.05087.x
更新日期:1998-04-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1997.tb00735.x
更新日期:1997-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2001.025003218.x
更新日期:2001-03-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:2009-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-02-01 00:00:00