Combined double lung-liver transplantation for cystic fibrosis without cardio-pulmonary by-pass.
Sequential bilateral single lung-liver transplantation (SBSL-LTx) is a therapeutic option for patients with end stage lung and liver disease (ESLLD) due to cystic fibrosis (CF). A few cases have been reported, all of them were performed with the use of cardio-pulmonary by-pass (CPB). We performed SBSL-LTx in three young men affected by CF. All the recipients had respiratory failure and portal hypertension with hypersplenism. Along with lung transplants, two patients received a whole liver graft and one an extended right graft from an in situ split liver. During transplantation neither CPB nor veno-venous by-pass (VVB) were employed. Immunosuppression was based on basiliximab, tacrolimus, steroids and azathioprine. The three recipients are alive with a median follow-up of 670 days (range 244-1,533). Combined SBSL-LTx is a complex but effective procedure for the treatment of ESLLD due to CF, not necessarily requiring the use of CPB or VVB.
Corno
V
V
General Surgery III Liver and Lung Transplantation Center, Ospedali Riuniti, Bergamo, Italy. vcorno@ospedaliriuniti.bergamo.it
Dezza
M C
MC
Lucianetti
A
A
Codazzi
D
D
Carrara
B
B
Pinelli
D
D
Parigi
P C
PC
Guizzetti
M
M
Strazzabosco
M
M
Melzi
M L
ML
Gaffuri
G
G
Sonzogni
V
V
Rossi
A
A
Fagiuoli
S
S
Colledan
M
M
D000328:Adult; D002315:Cardiopulmonary Bypass; D003550:Cystic Fibrosis / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D017093:Liver Failure / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008171:Lung Diseases / Q000209:etiology / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D016896:Treatment Outcome