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.
SARS-CoV-2 pandemic
bridge to transplant
extracorporeal membrane oxygenation
lung transplant
pulmonary hypertension
right heart failure
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
revised:
16
12
2021
received:
07
10
2021
accepted:
03
01
2022
pubmed:
10
1
2022
medline:
5
8
2022
entrez:
9
1
2022
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 35000286
doi: 10.1111/ajt.16949
pii: S1600-6135(22)00005-3
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
2094-2098Informations de copyright
© 2022 The American Society of Transplantation and the American Society of Transplant Surgeons.
Références
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