This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hlozek, C. C Articles by Perl, M. Search for Related Content PubMed PubMed Citation Articles by Hlozek, C. C Articles by Perl, M. Social Bookmarking                   What's this?

Cardiopulmonary bypass (CPB) for lung transplantation

Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio

Nicholas G Smedira

Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio

Thomas J Kirby

Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio

Amit N Patel

Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio

Mary Perl

Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio

Surgeons have often been reluctant to use cardiopulmonary bypass (CPB) during single (SLTx) and double lung (DLTx) transplantation surgery because of the potential adverse sequelae of CPB including haemorrhage and activation of complement leading to sequestration of neutrophils and platelets in the pulmonary capillary bed, endothelial damage, increased capillary permeability and pulmonary oedema. To clarify the effect of CPB on lung transplant recipients, we reviewed our last four years’ experience in 74 patients of whom 30 required CPB support. Indications for CPB were mean pulmonary artery pressure of greater than 50 mmHg, haemodynamic instability, hypoxia or hypercarbia. Patients undergoing SLTx were placed on CPB via the femoral artery and vein, while those undergoing DLTx were cannulated in the standard fashion using the ascending aorta and right atrium. All patients were administered aprotinin prior to CPB. Intraoperatively and postoperatively, haemorrhage was not a major problem. The 30-day mortality in the CPB group and the non-CPB group were 20% and 4.6%, respectively which was not statistically significant (p = 0.06). We conclude that CPB during lung transplantation is a safe, effective method to support these severely ill patients and should not be avoided because of concerns over adverse sequelae of CPB on postoperative graft function.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				K. Subramaniam and J.-P. Yared Management of Pulmonary Hypertension in the Operating Room Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2007; 11(2): 119 - 136. [Abstract] [PDF]

				C. Aigner, W. Wisser, S. Taghavi, G. Lang, P. Jaksch, D. Czyzewski, and W. Klepetko Institutional experience with extracorporeal membrane oxygenation in lung transplantation Eur. J. Cardiothorac. Surg., March 1, 2007; 31(3): 468 - 474. [Abstract] [Full Text] [PDF]

				J. G. Byrne, M. Leacche, A. K. Agnihotri, S. Paul, R. Bueno, D. J. Mathisen, and D. J. Sugarbaker The Use of Cardiopulmonary Bypass During Resection of Locally Advanced Thoracic Malignancies: A 10-Year Two-Center Experience Chest, April 1, 2004; 125(4): 1581 - 1586. [Abstract] [Full Text] [PDF]

				W. Y. Szeto, D. Kreisel, G. C. Karakousis, A. Pochettino, D. H. Sterman, R. M. Kotloff, S. M. Arcasoy, D. A. Zisman, N. P. Blumenthal, R. J. Gallop, et al. Cardiopulmonary bypass for bilateral sequential lung transplantation in patients with chronic obstructive pulmonary disease without adverse effect on lung function or clinical outcome J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 241 - 249. [Abstract] [Full Text] [PDF]

				K S Nair, D R Lawrence, P P Punjabi, and K M Taylor Indications for cardiopulmonary bypass in non-cardiac operations Perfusion, May 1, 2002; 17(3): 161 - 166. [PDF]