Case report: Paracorporeal lung assist device for 215 days as a bridge-to-lung transplantation in a patient with bronchopulmonary dysplasia and severe pulmonary hypertension.

病例报告 ： 支气管肺发育不良和严重肺动脉高压患者的桥肺移植 215 天。

• 发表时间: 2023
• 来源期刊: Front Transplant
• DOI: 10.3389/frtra.2023.1197906
• PMID: 38993847
• 文章类型: Case Reports
• 作者列表: Michel SG,Hanuna M,Pattathu J,Pabst von Ohain J,Schneider C,Kauke T,Kneidinger N,Behr J,Milger K,Barton J,Veit T,Kamla C,Mueller C,Dzieciol R,Christen L,Irlbeck M,Tomasi R,Abicht J,Scheiermann P,Feuerecker M,Dalla-Pozza R,Fischer M,Jakob A,Hermann M,Haas N,Hagl C,Hörer J

关键词: ECMOextracorporeal membrane oxygenation; bridge-to-lung transplant; lung assist device; lung transplantation; pulmonary hypertension

Abstract

Pulmonary hypertension (PH) is a known and life limiting complication of preterm born young adults with bronchopulmonary dysplasia (BPD), ultimately leading to progressive right ventricular (RV) failure. Prognosis remains poor, especially in patients unresponsive to modern vasoactive pharmacotherapy. Therefore, lung transplantation presents the treatment of choice to avert cardiac failure. With limited donor organ availability and long waiting times, the implantation of a paracorporeal lung assist device (PLAD) is a way to bridge the patient as an alternative to veno-arterial ECMO. Herein, we present the case of a prematurely born 23-year-old female, who developed severe PH due to BPD and consequently experienced therapy refractory RV failure. Urgent PLAD implantation was performed and the patient successfully underwent double-lung transplantation after 215 days of PLAD support. No major PLAD-associated complications occurred and full recovery of RV function could be observed after double-lung transplantation.

摘要

肺动脉高压（PH）是早产儿支气管肺发育不良（BPD）的已知且限制生命的并发症，最终导致进行性右心室（RV）衰竭。预后仍然很差，尤其是对现代血管活性药物治疗无反应的患者。因此,肺移植是避免心力衰竭的首选治疗方法。由于供体器官的可用性有限且等待时间长，植入体外肺辅助装置(PLAD)是一种替代静脉动脉ECMO的方法,可以使患者桥接.在这里，我们介绍了一个早产的23岁女性，由于BPD而发展为严重的PH，因此经历了治疗难治性RV衰竭。进行了紧急PLAD植入，并在PLAD支持215天后成功进行了双肺移植。双肺移植后无PLAD相关并发症发生，RV功能完全恢复。