Transplante isolado de pulmão: experiência da Escola Paulista de Medicina
Autor(a) principal: | |
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Data de Publicação: | 1991 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0102-76381991000300001 http://repositorio.unifesp.br/handle/11600/293 |
Resumo: | Two cases of left single lung transplantation for pulmonary fibrosis are reported, one of a 50 years old white male who is alive and well 8 months after the transplantation and the other of a 36 years old female weighing 45 kg who received an upper lobe transplantation from a 85 kg donor. This patient died of multiple organ failure in the 8th postoperative day due to complications related to an unexplained cardiac tamponade and also possible rejection but was able to maintain good ventilatory and hemodynamic conditions in the first 3 days following transplantation; radiographic studies showed adequate expansion of the transplanted lobe. Autopsy revealed no problems in the anastomotic sites and signs of difuse bronchopneumonia. In the two cases a flap of pericardial fat was utilized instead of omental flap to protect the bronchial anastomosis and in the first case a telescoping anastomotic technique was done. Both patients received corticoids since the begining and the immunossupression protocol consisted of cyclosporin, prednisone and azathioprine and had no airways complications. In spite of being an initial experience, the authors express their hope in single lung and lobe transplantation for selected terminal lung diseases and in the near future also as an alternative in the surgical treatment of complex congenital cardiac anomalies. |
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Transplante isolado de pulmão: experiência da Escola Paulista de MedicinaSingle lung transplantation: experience of Escola Paulista de Medicinalung transplantationtransplante pulmonarTwo cases of left single lung transplantation for pulmonary fibrosis are reported, one of a 50 years old white male who is alive and well 8 months after the transplantation and the other of a 36 years old female weighing 45 kg who received an upper lobe transplantation from a 85 kg donor. This patient died of multiple organ failure in the 8th postoperative day due to complications related to an unexplained cardiac tamponade and also possible rejection but was able to maintain good ventilatory and hemodynamic conditions in the first 3 days following transplantation; radiographic studies showed adequate expansion of the transplanted lobe. Autopsy revealed no problems in the anastomotic sites and signs of difuse bronchopneumonia. In the two cases a flap of pericardial fat was utilized instead of omental flap to protect the bronchial anastomosis and in the first case a telescoping anastomotic technique was done. Both patients received corticoids since the begining and the immunossupression protocol consisted of cyclosporin, prednisone and azathioprine and had no airways complications. In spite of being an initial experience, the authors express their hope in single lung and lobe transplantation for selected terminal lung diseases and in the near future also as an alternative in the surgical treatment of complex congenital cardiac anomalies.Relatam-se dois casos de transplante pulmonar isolado à esquerda, em portadores de fibrose pulmonar, um em paciente do sexo maculino de 50 anos de idade, que se encontra no 8º mês de pós-operatório, livre de complicações, e outro de mulher de 36 anos pesando 45 kg, que recebeu o lobo superior de um doador de 85 kg. Esta manteve, nos três primeiros dias de pós-operatório, boas condições ventilatórias e hemodinâmicas e as radiografias mostraram boa expansão do lobo do doador. Teve quadro provável de rejeição e, a seguir, tamponamento cardíaco inesperado complicado por parada cardíaca, culminando com falência de múltiplos órgãos e óbito no 8º dia. A necropsia revelou integridade das anastomoses e broncopneumonia. Nos dois casos substituiu-se o omento por retalhos pediculados de gordura pericárdica para proteção das anastomoses e, no primeiro caso, empregou-se técnica de telescopagem na anastomose brônquica. Ambos pacientes receberam corticóides desde o início do esquema de imunossupressão, que constou de ciclosporina, prednisona e azatioprina. Concluem os autores que a introdução precoce do corticóide não interferiu na anastomose brônquica em um dos casos e, possivelmente, no outro; a feitura da anastomose brônquica em telescopagem no primeiro caso conferiu bom diâmetro e não mostrou estenose tardia; o enxerto do lobo superior no segundo caso ocupou o hemitórax do receptor e mostrou normalidade funcional até que surgissem complicações cardiovasculares. Sugerem a possibilidade futura do transplante de lobo em pacientes do grupo pediátrico portadores de cardiopatias congênitas com hipertensão pulmonar irreversível, onde a falta de doadores adequados constitui séria limitação.Escola Paulista de Medicina Grupo de Transplante PulmonarUNIFESP, EPM, Grupo de Transplante PulmonarSciELOSociedade Brasileira de Cirurgia CardiovascularUniversidade Federal de São Paulo (UNIFESP)Succi, José Ernesto [UNIFESP]Forte, Vicente [UNIFESP]Perfeito, João Aléssio Juliano [UNIFESP]Beppu, Osvaldo Shigueomi [UNIFESP]Martinez, José Antônio Baddini [UNIFESP]Buffolo, Enio [UNIFESP]Leao, Luiz Eduardo Villaca [UNIFESP]Santos, Manuel Lopes [UNIFESP]2015-06-14T13:24:22Z2015-06-14T13:24:22Z1991-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion137-146application/pdfhttp://dx.doi.org/10.1590/S0102-76381991000300001Revista Brasileira de Cirurgia Cardiovascular. Sociedade Brasileira de Cirurgia Cardiovascular, v. 6, n. 3, p. 137-146, 1991.10.1590/S0102-76381991000300001S0102-76381991000300001.pdf0102-7638S0102-76381991000300001http://repositorio.unifesp.br/handle/11600/293porRevista Brasileira de Cirurgia Cardiovascularinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-10-10T10:29:57Zoai:repositorio.unifesp.br/:11600/293Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-10-10T10:29:57Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina Single lung transplantation: experience of Escola Paulista de Medicina |
title |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina |
spellingShingle |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina Succi, José Ernesto [UNIFESP] lung transplantation transplante pulmonar |
title_short |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina |
title_full |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina |
title_fullStr |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina |
title_full_unstemmed |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina |
title_sort |
Transplante isolado de pulmão: experiência da Escola Paulista de Medicina |
author |
Succi, José Ernesto [UNIFESP] |
author_facet |
Succi, José Ernesto [UNIFESP] Forte, Vicente [UNIFESP] Perfeito, João Aléssio Juliano [UNIFESP] Beppu, Osvaldo Shigueomi [UNIFESP] Martinez, José Antônio Baddini [UNIFESP] Buffolo, Enio [UNIFESP] Leao, Luiz Eduardo Villaca [UNIFESP] Santos, Manuel Lopes [UNIFESP] |
author_role |
author |
author2 |
Forte, Vicente [UNIFESP] Perfeito, João Aléssio Juliano [UNIFESP] Beppu, Osvaldo Shigueomi [UNIFESP] Martinez, José Antônio Baddini [UNIFESP] Buffolo, Enio [UNIFESP] Leao, Luiz Eduardo Villaca [UNIFESP] Santos, Manuel Lopes [UNIFESP] |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Succi, José Ernesto [UNIFESP] Forte, Vicente [UNIFESP] Perfeito, João Aléssio Juliano [UNIFESP] Beppu, Osvaldo Shigueomi [UNIFESP] Martinez, José Antônio Baddini [UNIFESP] Buffolo, Enio [UNIFESP] Leao, Luiz Eduardo Villaca [UNIFESP] Santos, Manuel Lopes [UNIFESP] |
dc.subject.por.fl_str_mv |
lung transplantation transplante pulmonar |
topic |
lung transplantation transplante pulmonar |
description |
Two cases of left single lung transplantation for pulmonary fibrosis are reported, one of a 50 years old white male who is alive and well 8 months after the transplantation and the other of a 36 years old female weighing 45 kg who received an upper lobe transplantation from a 85 kg donor. This patient died of multiple organ failure in the 8th postoperative day due to complications related to an unexplained cardiac tamponade and also possible rejection but was able to maintain good ventilatory and hemodynamic conditions in the first 3 days following transplantation; radiographic studies showed adequate expansion of the transplanted lobe. Autopsy revealed no problems in the anastomotic sites and signs of difuse bronchopneumonia. In the two cases a flap of pericardial fat was utilized instead of omental flap to protect the bronchial anastomosis and in the first case a telescoping anastomotic technique was done. Both patients received corticoids since the begining and the immunossupression protocol consisted of cyclosporin, prednisone and azathioprine and had no airways complications. In spite of being an initial experience, the authors express their hope in single lung and lobe transplantation for selected terminal lung diseases and in the near future also as an alternative in the surgical treatment of complex congenital cardiac anomalies. |
publishDate |
1991 |
dc.date.none.fl_str_mv |
1991-12-01 2015-06-14T13:24:22Z 2015-06-14T13:24:22Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0102-76381991000300001 Revista Brasileira de Cirurgia Cardiovascular. Sociedade Brasileira de Cirurgia Cardiovascular, v. 6, n. 3, p. 137-146, 1991. 10.1590/S0102-76381991000300001 S0102-76381991000300001.pdf 0102-7638 S0102-76381991000300001 http://repositorio.unifesp.br/handle/11600/293 |
url |
http://dx.doi.org/10.1590/S0102-76381991000300001 http://repositorio.unifesp.br/handle/11600/293 |
identifier_str_mv |
Revista Brasileira de Cirurgia Cardiovascular. Sociedade Brasileira de Cirurgia Cardiovascular, v. 6, n. 3, p. 137-146, 1991. 10.1590/S0102-76381991000300001 S0102-76381991000300001.pdf 0102-7638 S0102-76381991000300001 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Revista Brasileira de Cirurgia Cardiovascular |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
137-146 application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268448210944000 |