A staged approach for a lung–liver transplant patient using ex vivo reconditioned lungs first followed by an urgent liver transplantation

Combined lung–liver transplantation is a logistically challenging procedure hampered by shortage of organ donors. We describe the case of a young patient with end‐stage lung disease due to of cystic fibrosis and liver cirrhosis who needed combined lung–liver transplantation. The long waiting for thi...

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Bibliographic Details
Published inTransplant international Vol. 28; no. 1; pp. 129 - 133
Main Authors Van De Wauwer, Caroline, Verschuuren, Erik A. M., Nossent, George D., Bij, Wim, Hamer, Inez J., Klinkenberg, Theo J., Berg, Aad P., Boer, Marieke T., Mariani, Massimo A., Erasmus, Michiel E.
Format Journal Article
LanguageEnglish
Published England Blackwell Publishing Ltd 01.01.2015
Subjects
Adult
Cystic Fibrosis - surgery
donation after circulatory death
Edema - pathology
End Stage Liver Disease - surgery
ex vivo lung perfusion
Female
Humans
liver
Liver Cirrhosis - surgery
Liver Transplantation - methods
lung
Lung - pathology
Lung Diseases - surgery
Lung Transplantation - methods
Male
Perfusion - methods
Tissue Donors
transplantation
Treatment Outcome
Young Adult
lung
donation after circulatory death
liver
ex vivo lung perfusion
transplantation
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Summary:Combined lung–liver transplantation is a logistically challenging procedure hampered by shortage of organ donors. We describe the case of a young patient with end‐stage lung disease due to of cystic fibrosis and liver cirrhosis who needed combined lung–liver transplantation. The long waiting for this caused an interesting clinical dilemma. We decided to change our policy in this situation by listing him only for the lung transplantation and to apply for a high urgent liver transplantation if the liver failed after the lung transplantation. This strategy enabled us to use lungs treated with ex vivo lung perfusion (EVLP) from an unsuitable donor after circulatory death. After conditioning for 4 h via EVLP, the pO2 was 59.7 kPa. The lungs were transplanted successfully. He developed an acute‐on‐chronic liver failure for which he received a successful liver transplantation 19 days after the lung transplantation.
Bibliography:Conflicts of interest
The authors of this manuscript have no conflicts of interest to disclose.
ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:0934-0874
1432-2277
DOI:10.1111/tri.12408