TY - JOUR
T1 - Perioperative management of lung transplantations in patients with pulmonary arterial hypertension compared with that in patients with lymphangiomyomatosis
AU - Adachi, Koko
AU - Kurosawa, Shin
AU - Wagatsuma, Toshihiro
AU - Yamamoto, Yoko
AU - Kameyama, Eri
AU - Nishino, Ryo
PY - 2013/5/1
Y1 - 2013/5/1
N2 - Background : 'The number of lung transplantation has tended to increase as a treatment for patients with pulmonary arterial hypertension (PAH) and lymphangiomyomatosis (LAM) in Japan. However, we have little evidence about the comparison of perioperative management in patients with PAH and that in patients with LAM. Methods : In this retrospective study, ten patients with PAH and seventeen patients with LAM who underwent the lung transplantations between 2006 and 2011 were enrolled. Results : PAH patients received double lung transplantation with intraoperative cardiopulmonary bypass (CPB) support. Before anesthesia induction, percutaneous cardiopulmonary support (PCPS) was begun. Most of LAM patients received single lung transplantation without using CPB support and PCPS support before anesthesia induction. But sometimes during an operation PCPS support was necessary. Postoperative PCPS support showed no significant differences between PAH and LAM. The four year survival rate was 80% (PAH) and 87.8% (LAM). PaO2/FIO2 in patients with PAH and in those with LAM, %FEV1.0 in those with LAM after surgery improved when compared to those before surgery. Conclusions : The large difference in perioperative management between patients with PAH and those with LAM is an important knowledge for anesthesist.
AB - Background : 'The number of lung transplantation has tended to increase as a treatment for patients with pulmonary arterial hypertension (PAH) and lymphangiomyomatosis (LAM) in Japan. However, we have little evidence about the comparison of perioperative management in patients with PAH and that in patients with LAM. Methods : In this retrospective study, ten patients with PAH and seventeen patients with LAM who underwent the lung transplantations between 2006 and 2011 were enrolled. Results : PAH patients received double lung transplantation with intraoperative cardiopulmonary bypass (CPB) support. Before anesthesia induction, percutaneous cardiopulmonary support (PCPS) was begun. Most of LAM patients received single lung transplantation without using CPB support and PCPS support before anesthesia induction. But sometimes during an operation PCPS support was necessary. Postoperative PCPS support showed no significant differences between PAH and LAM. The four year survival rate was 80% (PAH) and 87.8% (LAM). PaO2/FIO2 in patients with PAH and in those with LAM, %FEV1.0 in those with LAM after surgery improved when compared to those before surgery. Conclusions : The large difference in perioperative management between patients with PAH and those with LAM is an important knowledge for anesthesist.
KW - Assisted circulation
KW - Lung transplantation
KW - Lymphangiomyomatosis
KW - Pulmonary arterial hypertension
KW - Respiratory function
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M3 - Article
C2 - 23772531
AN - SCOPUS:84878077766
VL - 62
SP - 573
EP - 579
JO - Japanese Journal of Anesthesiology
JF - Japanese Journal of Anesthesiology
SN - 0021-4892
IS - 5
ER -