非理想供体肺在肺移植中的处理体会

目的:报告采用非理想供体肺进行同种异体肺移植的近期效果。方法:回顾性分析3例采用非理想供体肺的临床肺移植效果。例1供肺切除部分左上叶后施行左单肺移植并同期右肺减容术,例2供肺双上叶切除部分后施行序贯式双肺移植,例3供体胸腔存在广泛密集的粘连,用剪刀锐性分离切取后用于右肺移植。结果:例1术后恢复顺利,移植肺未出现明显并发症。例2术后5d出现短期漏气,经闭式引流而愈,术后d32死于曲霉菌感染导致的呼吸道大出血。例3术后d1再次开胸止血,此后顺利出院并存活至今。结论:经过适当处理,一些非理想供体肺也可以有效地用于肺移植。

Lung Transplantation with Marginal Graft Lung

Objective: To report the experience of lung transplantation with marginal donors.Method: 3 cases receiving lung transplantation with marginal donors were analyzed respectively.In case 1,left single lung transplantation and contra-lateral lung volume reduction were performed with partially cut of graft lung.In case 2,bilateral sequential single lung transplantation were performed with partially cut of bilateral graft up lobes.In the remained case,right lung transplantation was performed using graft lung harvested from thoracic cavity of extensive edhesion.Result: The first case recovered after operation without obvious complication.The second case shortly suffered air leakage and died of abrupt bronchorrhea 32 days after lung transplantation result from aspergillus infectionthe.The last case experienced exploratory thoracotomy one day after lung transplantation because of active hemothorax.Conclusion: Some marginal graft lungs can be used for transplantation after properly managed.