Combined Liver and Lung Transplantation With Extended Normothermic Lung Preservation in a Patient With End‐Stage Emphysema Complicated by Drug‐Induced Acute Liver Failure
Isolated lung transplantation (LuTx) and liver transplantation are established treatments for irreversible lung and liver failure. Combined liver and lung transplantation (cLiLuTx) is a less common, but approved therapy of combined organ failure, mostly applied in patients suffering from progressive...
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Veröffentlicht in: | American journal of transplantation 2014-10, Vol.14 (10), p.2412-2416 |
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creator | Ceulemans, L. J. Monbaliu, D. Verslype, C. van der Merwe, S. Laleman, W. Vos, R. Neyrinck, A. Van Veer, H. De Leyn, P. Nevens, F. Pirenne, J. Verleden, G. Van Raemdonck, D. |
description | Isolated lung transplantation (LuTx) and liver transplantation are established treatments for irreversible lung and liver failure. Combined liver and lung transplantation (cLiLuTx) is a less common, but approved therapy of combined organ failure, mostly applied in patients suffering from progressive cystic fibrosis and advanced liver disease. We report a patient who was listed for LuTx due to end‐stage chronic obstructive pulmonary disease and who developed drug‐induced acute hepatic failure. The only therapeutic option was hyper‐urgent cLiLuTx. To correct the poor coagulation in order to reduce the per‐operative risk of bleeding, the liver was transplanted first. In anticipation of the longer lung preservation time, cold flushed lungs were preserved on a portable lung perfusion device for ex vivo normothermic perfusion for 11 h 15 min, transplanted sequentially off‐pump, and reperfused after a total ex vivo time of 13 h 32 min and 16 h for the first and second lung, respectively. Ten months later, the patient is doing well and no rejection occurred. Normothermic ex vivo lung perfusion may help to prolong preservation time, facilitating long‐distance transport and combined organ transplantation.
In a case of hyper‐urgent combined liver and lung transplantation, extended normothermic ex vivo lung perfusion allows prioritization of the liver transplantation. |
doi_str_mv | 10.1111/ajt.12856 |
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In a case of hyper‐urgent combined liver and lung transplantation, extended normothermic ex vivo lung perfusion allows prioritization of the liver transplantation.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/ajt.12856</identifier><identifier>PMID: 25098631</identifier><language>eng</language><publisher>Hoboken, NJ: Wiley</publisher><subject>Biological and medical sciences ; Chronic obstructive pulmonary disease, asthma ; Clinical research ; Cystic fibrosis ; drug toxicity ; dysfunction ; Emphysema - complications ; Emphysema - surgery ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; hepatology ; Humans ; liver (native) function ; Liver cirrhosis ; Liver Failure - complications ; Liver Failure - surgery ; Liver Transplantation ; Liver, biliary tract, pancreas, portal circulation, spleen ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; lung (allograft) function ; Lung Transplantation ; Medical sciences ; Middle Aged ; organ perfusion and preservation ; organ transplantation in general ; Other diseases. Semiology ; Pneumology ; practice ; Preservation ; pulmonology ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Transplants & implants</subject><ispartof>American journal of transplantation, 2014-10, Vol.14 (10), p.2412-2416</ispartof><rights>Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4886-ed070fca67005019ab3ed71847680fc201f4a6c822acccd9446bc274635fbca63</citedby><cites>FETCH-LOGICAL-c4886-ed070fca67005019ab3ed71847680fc201f4a6c822acccd9446bc274635fbca63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajt.12856$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajt.12856$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28945665$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25098631$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ceulemans, L. J.</creatorcontrib><creatorcontrib>Monbaliu, D.</creatorcontrib><creatorcontrib>Verslype, C.</creatorcontrib><creatorcontrib>van der Merwe, S.</creatorcontrib><creatorcontrib>Laleman, W.</creatorcontrib><creatorcontrib>Vos, R.</creatorcontrib><creatorcontrib>Neyrinck, A.</creatorcontrib><creatorcontrib>Van Veer, H.</creatorcontrib><creatorcontrib>De Leyn, P.</creatorcontrib><creatorcontrib>Nevens, F.</creatorcontrib><creatorcontrib>Pirenne, J.</creatorcontrib><creatorcontrib>Verleden, G.</creatorcontrib><creatorcontrib>Van Raemdonck, D.</creatorcontrib><title>Combined Liver and Lung Transplantation With Extended Normothermic Lung Preservation in a Patient With End‐Stage Emphysema Complicated by Drug‐Induced Acute Liver Failure</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>Isolated lung transplantation (LuTx) and liver transplantation are established treatments for irreversible lung and liver failure. Combined liver and lung transplantation (cLiLuTx) is a less common, but approved therapy of combined organ failure, mostly applied in patients suffering from progressive cystic fibrosis and advanced liver disease. We report a patient who was listed for LuTx due to end‐stage chronic obstructive pulmonary disease and who developed drug‐induced acute hepatic failure. The only therapeutic option was hyper‐urgent cLiLuTx. To correct the poor coagulation in order to reduce the per‐operative risk of bleeding, the liver was transplanted first. In anticipation of the longer lung preservation time, cold flushed lungs were preserved on a portable lung perfusion device for ex vivo normothermic perfusion for 11 h 15 min, transplanted sequentially off‐pump, and reperfused after a total ex vivo time of 13 h 32 min and 16 h for the first and second lung, respectively. Ten months later, the patient is doing well and no rejection occurred. Normothermic ex vivo lung perfusion may help to prolong preservation time, facilitating long‐distance transport and combined organ transplantation.
In a case of hyper‐urgent combined liver and lung transplantation, extended normothermic ex vivo lung perfusion allows prioritization of the liver transplantation.</description><subject>Biological and medical sciences</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Clinical research</subject><subject>Cystic fibrosis</subject><subject>drug toxicity</subject><subject>dysfunction</subject><subject>Emphysema - complications</subject><subject>Emphysema - surgery</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>hepatology</subject><subject>Humans</subject><subject>liver (native) function</subject><subject>Liver cirrhosis</subject><subject>Liver Failure - complications</subject><subject>Liver Failure - surgery</subject><subject>Liver Transplantation</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>lung (allograft) function</subject><subject>Lung Transplantation</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>organ perfusion and preservation</subject><subject>organ transplantation in general</subject><subject>Other diseases. Semiology</subject><subject>Pneumology</subject><subject>practice</subject><subject>Preservation</subject><subject>pulmonology</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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J.</creator><creator>Monbaliu, D.</creator><creator>Verslype, C.</creator><creator>van der Merwe, S.</creator><creator>Laleman, W.</creator><creator>Vos, R.</creator><creator>Neyrinck, A.</creator><creator>Van Veer, H.</creator><creator>De Leyn, P.</creator><creator>Nevens, F.</creator><creator>Pirenne, J.</creator><creator>Verleden, G.</creator><creator>Van Raemdonck, D.</creator><general>Wiley</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201410</creationdate><title>Combined Liver and Lung Transplantation With Extended Normothermic Lung Preservation in a Patient With End‐Stage Emphysema Complicated by Drug‐Induced Acute Liver Failure</title><author>Ceulemans, L. J. ; Monbaliu, D. ; Verslype, C. ; van der Merwe, S. ; Laleman, W. ; Vos, R. ; Neyrinck, A. ; Van Veer, H. ; De Leyn, P. ; Nevens, F. ; Pirenne, J. ; Verleden, G. ; Van Raemdonck, D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4886-ed070fca67005019ab3ed71847680fc201f4a6c822acccd9446bc274635fbca63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Biological and medical sciences</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Clinical research</topic><topic>Cystic fibrosis</topic><topic>drug toxicity</topic><topic>dysfunction</topic><topic>Emphysema - complications</topic><topic>Emphysema - surgery</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>hepatology</topic><topic>Humans</topic><topic>liver (native) function</topic><topic>Liver cirrhosis</topic><topic>Liver Failure - complications</topic><topic>Liver Failure - surgery</topic><topic>Liver Transplantation</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>lung (allograft) function</topic><topic>Lung Transplantation</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>organ perfusion and preservation</topic><topic>organ transplantation in general</topic><topic>Other diseases. Semiology</topic><topic>Pneumology</topic><topic>practice</topic><topic>Preservation</topic><topic>pulmonology</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. 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J.</au><au>Monbaliu, D.</au><au>Verslype, C.</au><au>van der Merwe, S.</au><au>Laleman, W.</au><au>Vos, R.</au><au>Neyrinck, A.</au><au>Van Veer, H.</au><au>De Leyn, P.</au><au>Nevens, F.</au><au>Pirenne, J.</au><au>Verleden, G.</au><au>Van Raemdonck, D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combined Liver and Lung Transplantation With Extended Normothermic Lung Preservation in a Patient With End‐Stage Emphysema Complicated by Drug‐Induced Acute Liver Failure</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2014-10</date><risdate>2014</risdate><volume>14</volume><issue>10</issue><spage>2412</spage><epage>2416</epage><pages>2412-2416</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>Isolated lung transplantation (LuTx) and liver transplantation are established treatments for irreversible lung and liver failure. Combined liver and lung transplantation (cLiLuTx) is a less common, but approved therapy of combined organ failure, mostly applied in patients suffering from progressive cystic fibrosis and advanced liver disease. We report a patient who was listed for LuTx due to end‐stage chronic obstructive pulmonary disease and who developed drug‐induced acute hepatic failure. The only therapeutic option was hyper‐urgent cLiLuTx. To correct the poor coagulation in order to reduce the per‐operative risk of bleeding, the liver was transplanted first. In anticipation of the longer lung preservation time, cold flushed lungs were preserved on a portable lung perfusion device for ex vivo normothermic perfusion for 11 h 15 min, transplanted sequentially off‐pump, and reperfused after a total ex vivo time of 13 h 32 min and 16 h for the first and second lung, respectively. Ten months later, the patient is doing well and no rejection occurred. Normothermic ex vivo lung perfusion may help to prolong preservation time, facilitating long‐distance transport and combined organ transplantation.
In a case of hyper‐urgent combined liver and lung transplantation, extended normothermic ex vivo lung perfusion allows prioritization of the liver transplantation.</abstract><cop>Hoboken, NJ</cop><pub>Wiley</pub><pmid>25098631</pmid><doi>10.1111/ajt.12856</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Biological and medical sciences Chronic obstructive pulmonary disease, asthma Clinical research Cystic fibrosis drug toxicity dysfunction Emphysema - complications Emphysema - surgery Female Gastroenterology. Liver. Pancreas. Abdomen hepatology Humans liver (native) function Liver cirrhosis Liver Failure - complications Liver Failure - surgery Liver Transplantation Liver, biliary tract, pancreas, portal circulation, spleen Liver. Biliary tract. Portal circulation. Exocrine pancreas lung (allograft) function Lung Transplantation Medical sciences Middle Aged organ perfusion and preservation organ transplantation in general Other diseases. Semiology Pneumology practice Preservation pulmonology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Transplants & implants |
title | Combined Liver and Lung Transplantation With Extended Normothermic Lung Preservation in a Patient With End‐Stage Emphysema Complicated by Drug‐Induced Acute Liver Failure |
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