RESUMO
Cystic fibrosis (CF) affects multiple organs including the lung, liver, and pancreas. Lung transplant, liver transplant, and combined lung-liver transplant have become well-established therapies for CF patients with end-stage organ failure. Thus far, however, there has been limited experience with pancreas transplantation in CF. In this report, we detail the clinical history, transplant procedure, and post-operative recovery of a patient who underwent combined lung-liver-pancreas transplant for advanced CF.
Assuntos
Fibrose Cística , Transplante de Fígado/métodos , Transplante de Pulmão/métodos , Transplante de Pâncreas/métodos , Fibrose Cística/diagnóstico , Fibrose Cística/genética , Fibrose Cística/fisiopatologia , Fibrose Cística/cirurgia , Progressão da Doença , Humanos , Fígado/fisiopatologia , Fígado/cirurgia , Pulmão/fisiopatologia , Pulmão/cirurgia , Masculino , Pâncreas/fisiopatologia , Pâncreas/cirurgia , Assistência Perioperatória/métodos , Resultado do Tratamento , Adulto JovemRESUMO
Liver transplantation is the optimal treatment for end-stage liver disease but is limited by the severe shortage of donor organs. This shortage has prompted increased utilization of marginal grafts from DCD and extended criteria donors, which poorly tolerate cold storage in comparison to standard criteria grafts. Ex-vivo liver perfusion (EVLP) technology has emerged as a potential alternative to cold storage for organ preservation, but there is no consensus regarding the optimal temperature or conditions for EVLP. Herein, we review recent advances in both pre-clinical and clinical studies, organized by perfusion temperature (hypothermic, subnormothermic, normothermic).