Combined heart-liver transplantation with extended cardiopulmonary bypass

We report a case of combined heart and liver transplantation for familial amyloid polyneuropathy. This is the first such combined transplant performed in Asia, and differs from previously described cases, in that cardiopulmonary bypass was continued at partial flow during liver transplantation in ou...

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Bibliographic Details
Published in:	Singapore medical journal Vol. 52; no. 3; p. e48
Main Authors:	Marriott, A J, Hwang, N C, Lai, F O, Tan, C K, Tan, Y M, Lim, C H, Boey, S K, Tay, S M, Cheow, P C, Lim, Y P, Chan, T, Loh, K, Kwok, B, Chung, A, Sivathasan, C
Format:	Journal Article
Language:	English
Published:	Singapore 01-03-2011
Subjects:	Amyloid Neuropathies, Familial - therapy Cardiopulmonary Bypass - methods Heart Failure - therapy Heart Transplantation - methods Hemodynamics Humans Liver - pathology Liver - surgery Liver Failure - therapy Liver Transplantation - methods Male Middle Aged Reperfusion Treatment Outcome
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Summary:	We report a case of combined heart and liver transplantation for familial amyloid polyneuropathy. This is the first such combined transplant performed in Asia, and differs from previously described cases, in that cardiopulmonary bypass was continued at partial flow during liver transplantation in our case. This was done in order to provide haemodynamic support to the cardiac graft and to protect it from the impending reperfusion insult that frequently accompanies liver transplantation. The utility of this management course is discussed, along with its actual and potential complications. We also describe the impact of a lung-protective ventilation strategy employed during cardiac transplantation.
ISSN:	0037-5675