同种异体心肺联合移植术一例

HeartLung Homoplastic Transplantation:A Report of One Case

于１９９２年２月９日为１例原发性肺动脉高压并进行性心力衰竭垂危患者作了心肺联合移植术。方法全麻、中低温、全心肺转流下进行同种异体全心肺联合移植术。结果术中顺利，心脏自动复跳，血流动力学稳定，血液分析正常。患者术后１３０分钟后神志清醒，第３天拔去胸腔引流管，第４天出现血氧饱和度急速下降，第１７天多器官功能衰竭死亡。结论缺乏监测手段和心肺联合移植经验，将严重全身性霉菌感染误诊为排斥反应。

Objective Heartlung transplantation was performed in our hospital to rescue a patient suffered from primary pulmonary hypertension with advancing cardiac failure on February 9,1996. Methods Heartlung homoplastic transplantation was performed in general anesthesia,moderate hypothermia and complete cardiopulmonary bypass.Results The operation was smooth.The heart rebeated automatically.Hemadynamics was stable and blood analysis was normal.The patient became conscious 130 minutes postoperatively.The endotracheal intubation was eradicated 47 hours after operation and patient's respiratory and circulatory function was good.Three days later the intrathoracic drain tube was drew out.The oxygen saturation of blood went down rapidly on the fourth day.The patient died of multiple system organ failure on the 17th postoperative days. Conclusion Lack of monitoring methods and experiences,serious genenal mycotic infection was misdiagnosed as rejection,which led to death on the 17th postoperative day . Systemic serious mycotic infection was diagnosed by autopsy.