Intensive care on one case of combined heart-liver transplantation

( views:223, downloads:0 )
Author:
SHI Jia-wei(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
XIONG Jun()
DONG Nian-guo(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
LIU Jin-ping(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
ZHANG Jing(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
CAI Jie(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
LI Ping(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
CHEN Jian-feng(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
XIAO Shi-liang(Department of Cardiovascular Surgery and Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China)
ZHENG Qi-chang()
Journal Title:
Chinese Journal of Organ Transplantation
Issue:
Volume 33, Issue 09, 2012
DOI:
10.3760/cma.j.issn.0254-1785.2012.09.007
Key Word:
Combined heart-liver transplantation;Perioperative care

Abstract: Objective To summarize the diagnosis and treatment of one case of combined heart liver transplantation. Methods On November 24, 2011, one case of combined heart-liver transplantation was performed on a patient with Ebstein's anomaly and tricuspid valve replacement after 5 years,complicated with congestive cirrhosis,liver failure dccompensation,preoperative heart failure Ⅲ degree and B grade of liver function Child-Pugh score. The operation was done with the graded cardiopulmonary bypass assisted mode:first creating the vena cava-aortic bypass to complete heart transplantation, second creating the femoral vein-ascending aorta bypass to complete liver transplantation,and third stopping and neutralizing.The aortic cross-clamping time was 54 min and the an hepatic phase was 38 min.The total time of three times of cardiopulmonary bypass was 199 min and the total time-consuming of operation was 517 min. The patient was given basiliximab +methylprednisolone for immune induction therapy, and tacrolimus + mycophenolate mofetil +prednisone solution for anti-rejection. After operation, liver protecting treatment, anti-infection therapy and nutrition support therapy were given.Results The recipient died of multiple organ failure after 78 days.The mechanical ventilation treatment duration for this recipient was 78 days and ECMO adjuvant therapy for postoperative hypoxemia time lasted 63 days.Conclusion The combined heart liver transplantation is an effective measures for treatment of heart and liver failure.

  • [1]Starzl TE,Bilheimer DW,Bahnson HT, et al. Heart-liver transplantation in a patient with familial hypercholcsterolaemia Lancet,1984,1 (8391):1382-1383.
  • [2]Nardo B,Beltempo P,Bertelli R,et al.Combined heart and liver transplantation in four adults with familial amyloidosis:experience of a single center.Transplant Proc,2004,36(3):645-647.
  • [3]Raichlin E,Daly RC,Rosen CB,et al.Combined heart and liver transplantation: a single-center experience.Transplantation,2009,88(2):219-225.
  • [4]Ahualli L,Stewart-Harris A,Bastianelli G,et al.Combined cardiohepatic transplantation due to severe heterozygous familiar hypcrcholcstercmia Type Ⅱ:first case in Argentina-a case report.Transplant Proc,2007,39(7):2449-2453.
  • [5]Marriott AJ,Hwang NC,Lai FO,et al.Combined heart-liver transplantation with extended cardiopulmonary bypass.Singapore Med J,2011,52(3):e48-51.
  • [6]李嵘,仲雅,路晓丽,等.1例心肝肾联合移植术后患者行连续性肾脏替代治疗的护理.护理学杂志(外科版),2010,25(2):30-31.
  • [7]Rauchfuss F,Breuer M,Dittmar Y,et al.Implantation of the liver during reperfusion of the heart in combined heart liver transplantation:own experience and review of the literature.Transplant Proc,2011,43(7):2707-2713.
  • [8]Amore AD,Botta L,Gallieri S. et al. Extracorporeal membrane oxygenator assistance as "bridge" to combined heart and liver transplantation. Transplant Proc,2006,38 (9):3004-3005.
  • [9]Diaz GC,Renz JF.Nishanian E,et al. Anesthetic nanagement of combined heart liver transplantation.J Cardiothorac Vasc Aaesthe,2007,21(2):253-256.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn