ECMO in severe hypoxemia post liver transplant for hepatopulmonary syndrome.

IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Jesús Emilio Barrueco-Francioni, María Carmen Martínez-González, Juan Francisco Martínez-Carmona, María Palma Benítez-Moreno, Cesar Aragón-González, Manuel Enrique Herrera-Gutiérrez
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引用次数: 0

Abstract

Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant patients, affecting between 10% and 30% of candidates. Historically, HPS was considered a contraindication for liver transplantation due to its association with high mortality rates. However, recent studies have shown improvements in pulmonary function post-transplant, leading to the inclusion of these patients as candidates. Despite this progress, approximately one-fifth of liver transplant recipients develop severe postoperative hypoxia, further complicating their clinical course and contributing to increased mortality. The management of post-transplant HPS involves various strategies, including extracorporeal membrane oxygenation (ECMO), although its use remains infrequently reported. Theoretical models suggest that oxygenation typically improves within 10 days post-transplant, while resolution of HPS may take 6-12 months, making ECMO an attractive possibility as a bridge to recovery in this population. We present a case were ECMO was used in this context.

肝移植后严重低氧血症的肝肺综合征 ECMO。
肝肺综合征(HPS)是肝移植患者面临的一项重大挑战,10% 到 30% 的候选者会受到影响。一直以来,由于 HPS 与高死亡率有关,因此被认为是肝移植的禁忌症。然而,最近的研究表明,移植后肺功能有所改善,因此这些患者也被列为候选者。尽管取得了这一进展,但仍有约五分之一的肝移植受者在术后出现严重缺氧,使其临床过程进一步复杂化,并导致死亡率上升。移植后 HPS 的治疗涉及多种策略,包括体外膜肺氧合(ECMO),但其使用情况仍鲜有报道。理论模型表明,血氧饱和度通常在移植后 10 天内得到改善,而 HPS 的缓解可能需要 6-12 个月的时间,因此 ECMO 作为这一人群康复的桥梁具有吸引力。我们介绍了一例在这种情况下使用 ECMO 的病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Artificial Organs
International Journal of Artificial Organs 医学-工程:生物医学
CiteScore
3.40
自引率
5.90%
发文量
92
审稿时长
3 months
期刊介绍: The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.
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