Volume 10 Issue 1
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Lin Ting, Wu Qifei, Ye Chunjuan, et al. Experience of perioperative treatment of lung transplantation: report of 7 cases[J]. ORGAN TRANSPLANTATION, 2019, 10(1): 74-78. doi: 10.3969/j.issn.1674-7445.2019.01.011
Citation: Lin Ting, Wu Qifei, Ye Chunjuan, et al. Experience of perioperative treatment of lung transplantation: report of 7 cases[J]. ORGAN TRANSPLANTATION, 2019, 10(1): 74-78. doi: 10.3969/j.issn.1674-7445.2019.01.011
shu

Experience of perioperative treatment of lung transplantation: report of 7 cases

doi: 10.3969/j.issn.1674-7445.2019.01.011

  • Surgical Intensive Care Unit, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China

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  • Corresponding author: Fu Junke, Email: xiaoyishuo@163.com; Liu Chang, Email: eyrechang@126.com
  • Received Date: 2018-10-20
    Available Online: 2021-01-19
  • Publish Date: 2019-01-15
    Abstract
  •   Objective  To summarize the experience of perioperative treatment of lung transplantation for end-stage lung disease.  Methods  Perioperative clinical data of 7 recipients undergoing lung transplantation were retrospectively analyzed, including 3 cases with bilateral lung transplantation and 4 cases with unilateral lung transplantation. The perioperative status and clinical prognosis of lung transplantation recipients were observed.  Results  The operation time of 7 lung transplantation recipients was (344±133) min. Cold ischemia time was (236±74) min in 4 cases of single-lung transplantation and (480±120) min in 3 cases of bilateral-lung transplantation. The length of Intensive care unit(ICU) stay was 21 (13-25) d and the length of hospital stay was 101 (64-117) d. In the first 3 d after surgery, the daily fluid output was significantly larger than the fluid input (all P < 0.05). The arterial oxygen partial pressure (PaO2) of lung transplantation recipients in the first 3 d after surgery was significantly elevated than preoperative level (all P < 0.05), whereas the arterial carbon dioxide pressure (PaCO2) did not significantly change (all P > 0.05). All recipients had pulmonary bacterial infection after lung transplantation, including 3 cases complicated with fungal infection. One recipient underwent exploratory thoracotomy for hemostasis due to active thoracic bleeding after operation, 1 recipient suffered from primary graft dysfunction (PGD) and 4 recipients received secondary endotracheal intubation. Two cases died after operation, 1 case died of septicemia caused by multidrug-resistant acinetobacter baumannii, the other case died of rejection reaction after self-terminating use of immunosuppressive agents. The remaining 5 cases were successfully discharged and recovered well. The longest survival period was 3.1 years.  Conclusions  In the perioperative management of lung transplantation, it has great significance to hold the surgical indications, monitor and manage postoperative refined fluid and hemodynamics, implement the strategy of protective pulmonary ventilation, and early diagnose and treat severe postoperative complications for the recipients of lung transplantation to safety through the perioperative period.

     

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