Severe hepatopulmonary syndrome with hypoxemia refractory to liver transplant: Recovery after 67 days of ECMO support

被引:7
|
作者
Piltcher-da-Silva, Rodrigo [1 ]
Chedid, Marcio Fernandes [1 ]
Grezzana Filho, Tomaz Jesus Maria [1 ]
Leipnitz, Ian [1 ]
de Araujo, Alexandre [1 ]
Gazzana, Marcelo Basso [1 ]
Saueressig, Mauricio Guidi [2 ]
Lorenzi, William [2 ]
Cardoni, Mario Gurvitez [1 ]
Bellaver, Priscila [1 ]
Alvares-da-Silva, Mario Reis [1 ]
Feier, Flavia Heinz [1 ]
Chedid, Aljamir Duarte [1 ]
Kruel, Cleber Rosito Pinto [1 ]
机构
[1] Hosp Clin Porto Alegre, Liver Transplantat, Ramiro Barcellos 2350, BR-90035903 Porto Alegre, RS, Brazil
[2] Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
来源
INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS | 2022年 / 45卷 / 01期
关键词
Liver transplantation; hepatopulmonary syndrome; ECMO; artificial kidney; apheresis & detoxification techniques; Artificial lung & respiratory support; Intravascular oxygenators; EXTRACORPOREAL MEMBRANE-OXYGENATION;
D O I
10.1177/0391398821989067
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Hepatopulmonary syndrome (HPS) is a complication of end stage liver disease (ESLD) and is manifested by severe hypoxemia, which usually responds to liver transplantation (LT). As compared to patients undergoing LT for other etiologies, patients with HPS present an increased risk of postoperative morbidity and mortality. There is no effective treatment for patients whose hypoxemia does not respond to LT. This subset of patients is at a highly increased risk of death. There are very few reports on the use of extracorporeal membrane oxygenation (ECMO) in this setting with rapid response. However, there is no prior report of ECMO utilization for longer than 4 weeks. We present the case of a 17 year-old male patient who underwent LT for ESLD secondary to chronic portal vein thrombosis and HPS. He received a liver from a deceased donor and presented with severe HPS after LT, requiring ECMO support for 67 days. The patient was discharged home and is breathing in ambient air. He is currently asymptomatic and has a normal liver function.
引用
收藏
页码:121 / 123
页数:3
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