title: A staged approach for a lung-liver transplant patient using ex vivo reconditioned lungs first followed by an urgent liver transplantation.
abstract: 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.
authors: Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors: Caroline
authors: C
authors: Van De Wauwer
authors: Erik A M
authors: EA
authors: Verschuuren
authors: George D
authors: GD
authors: Nossent
authors: Wim
authors: W
authors: van der Bij
authors: Inez J
authors: IJ
authors: den Hamer
authors: Theo J
authors: TJ
authors: Klinkenberg
authors: Aad P
authors: AP
authors: van den Berg
authors: Marieke T
authors: MT
authors: de Boer
authors: Massimo A
authors: MA
authors: Mariani
authors: Michiel E
authors: ME
authors: Erasmus
mesh_terms: D000328:Adult; D003550:Cystic Fibrosis / Q000601:surgery; D004487:Edema / Q000473:pathology; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D010477:Perfusion / Q000379:methods; D014019:Tissue Donors; D016896:Treatment Outcome; D055815:Young Adult
keywords: donation after circulatory death; ex vivo lung perfusion; liver; lung; transplantation