Extracorporeal circulation with low systemic heparinization during lung transplantation.
BACKGROUND
Some lung transplantation (LT) recipients suffer from pulmonary hypertension and right ventricular dysfunction or failure requiring extracorporeal circulation (ECC) to avoid catastrophic complications during surgery. The extracorporeal support usually requires systemic heparinization which is potentially associated with important side effects. We performed eight LT using preheparinized ECC circuits and an oxygenator associated with a lower level of systemic heparinization without evidence of perioperative complications.


METHODS
From May 2002 to May 2005, 8 patients (5 men and 3 women) of mean age 22.5 +/- 9.5 years underwent bilateral sequential lung transplantation (BSLT) for cystic fibrosis (n = 6) or idiopathic pulmonary fibrosis (n = 2). All procedures were performed with ECC through a femoro-femoral veno-arterial bypass with preheparinized circuits and an oxygenator.


RESULTS
No intraoperative mortality occurred. The mean ECC time was 147.8 +/- 31.3 minutes and the mean heparin administered was 3525 +/- 969.16 UI. No coagulopathy or thrombotic events were observed perioperatively.


CONCLUSIONS
Our study confirmed the efficacy and safety of prehepanized circuits and oxygenator for femoro-femoral veno-arterial bypass during LT for patients with severe pulmonary hypertension requiring ECC.
Pugliese
F
F
Dipartimento di Scienze Anestesiologiche, Medicina Critica e Terapia del Dolore, Italia. mavif@tiscali.it
Ruberto
F
F
Ferrazza
V
V
Bruno
K
K
Martelli
S
S
Celli
P
P
Perrella
S
S
Aimi
G
G
Diso
D
D
Anile
M
M
Venuta
F
F
Coloni
G F
GF
Pietropaoli
P
P
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000601:surgery; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D007839:Functional Laterality; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007430:Intraoperative Care; D016040:Lung Transplantation; D008297:Male; D011658:Pulmonary Fibrosis / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies
D000925:Anticoagulants; D006493:Heparin