Utilizing Lung Donors with Recent Massive Pulmonary Emboli and Chronic Thromboembolic Disease For Transplantation.

IF 8.9 2区 医学 Q1 SURGERY American Journal of Transplantation Pub Date : 2024-10-22 DOI:10.1016/j.ajt.2024.10.013
Aaron M Williams,Ranganath G Kathawate,Ramak Khosravi,Soraya Voigt,John C Haney
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Abstract

Organ availability remains a persistent problem in lung transplantation. The use of organs from donors with chronic thromboembolic disease has not been described. In this report, we discuss 2 lung transplant recipients who received organs from donors with acute bilateral pulmonary embolism. All organs underwent backtable pulmonary thromboendarterectomy (PTE) prior to implantation and notably showed evidence of chronic thromboembolic disease and subacute changes in the distal vasculature. Grafts were placed with both patients on veno-arterial (VA) extra-corporeal membrane oxygenation (ECMO). Both patients had unremarkable hospital courses with graft dysfunction scores of 0 at 48 and 72 hours. At follow-up, both patients remained free of graft rejection. We highlight the utility of lungs derived from chronic thromboembolic disease as a strategy to expand the organ pool.
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利用近期出现大面积肺栓塞和慢性血栓栓塞性疾病的肺捐献者进行移植。
器官供应仍然是肺移植中的一个老大难问题。使用患有慢性血栓栓塞疾病的供体器官的情况尚未见报道。在本报告中,我们讨论了两名肺移植受者,他们接受的器官来自患有急性双侧肺栓塞的供体。所有器官在植入前都进行了后台式肺血栓内膜切除术(PTE),并明显显示出慢性血栓栓塞性疾病和远端血管亚急性变化的证据。移植时,两名患者都接受了静脉-动脉(VA)体外膜肺氧合(ECMO)治疗。两名患者的住院过程均无异常,移植物功能障碍评分在 48 小时和 72 小时内均为 0。随访期间,两名患者均未出现移植物排斥反应。我们强调了从慢性血栓栓塞性疾病中提取的肺作为扩大器官库的一种策略的实用性。
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来源期刊
CiteScore
18.70
自引率
4.50%
发文量
346
审稿时长
26 days
期刊介绍: The American Journal of Transplantation is a leading journal in the field of transplantation. It serves as a forum for debate and reassessment, an agent of change, and a major platform for promoting understanding, improving results, and advancing science. Published monthly, it provides an essential resource for researchers and clinicians worldwide. The journal publishes original articles, case reports, invited reviews, letters to the editor, critical reviews, news features, consensus documents, and guidelines over 12 issues a year. It covers all major subject areas in transplantation, including thoracic (heart, lung), abdominal (kidney, liver, pancreas, islets), tissue and stem cell transplantation, organ and tissue donation and preservation, tissue injury, repair, inflammation, and aging, histocompatibility, drugs and pharmacology, graft survival, and prevention of graft dysfunction and failure. It also explores ethical and social issues in the field.
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