https://scholars.lib.ntu.edu.tw/handle/123456789/628780
標題: | Extreme size mismatch: bronchus compression by an oversized donor heart in small children | 作者: | HSUN-YI FU HENG-WEN CHOU YI-CHIA WANG NAI-KUAN CHOU YIH-SHARNG CHEN |
關鍵字: | Case report; Heart transplant; Pediatric; Size mismatch | 公開日期: | 十月-2022 | 卷: | 8 | 期: | 10 | 來源出版物: | Heliyon | 摘要: | Studies have suggested that a more liberal criterion of donor-recipient weight ratio (DRWR) is associated with superior waitlist survival without compromising posttransplant outcomes in selected critically ill patients. Successful transplantation of an extremely oversized donor heart into a small recipient is herein described. A 2-year-old girl accepted a size-mismatched adult donor heart offer (DRWR of 4.4) due to frequent complications with a left ventricular assist device. During the immediate postoperative period, spatial constraints within the thoracic cavity compromised graft function. Computed tomography revealed severe compression of the left bronchus due to the oversized allograft with lobar collapse of the left lung. With temporary extracorporeal membrane oxygenation support, graft function improved within 1 month after transplantation. Subsequent adaptive size remodeling of the transplanted heart with concomitant left bronchus re-expansion was observed within 6 months after transplantation. Despite a complicated posttransplant recovery, the patient was discharged home with minimal respiratory sequelae. Our report describes an alternative strategy for managing early morbidities related to an oversized graft and supports extending the criteria of size matching in pediatric heart transplantations. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/628780 | ISSN: | 2405-8440 | DOI: | 10.1016/j.heliyon.2022.e11095 |
顯示於: | 醫學系 |
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