Trasplante bipulmonar secuencial. Técnica y resultados de los tres primeros casos
Sequential double-lung transplantation. Technique and results in the first three cases
J. Astudillo Pomboa,1, C. Bravo Masgoretb, C. Margarit Creixellc, M.aL. Guillermo Rodríguezd, L. Tenorio Lópeze, Grupo de Trasplante Pulmonar *
a Servicio de Cirugía Torácica. Hospital General Universitario Vall d’Hebron. Barcelona
b Servicio de Neumología. Hospital General Universitario Vall d’Hebron. Barcelona
c Unidad de Trasplante Hepático. Hospital General Universitario Vall d’Hebron. Barcelona
d Servicio de Anestesia. Hospital General Universitario Vall d’Hebron. Barcelona
e Servicio Medicina Intensiva. Hospital General Universitario Vall d’Hebron. Barcelona
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"apellidos" => "Margarit Creixell" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "M.<span class="elsevierStyleSup">a</span>L." "apellidos" => "Guillermo Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "L." "apellidos" => "Tenorio López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 5 => array:2 [ "colaborador" => "Grupo de Trasplante Pulmonar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica. Hospital General Universitario Vall d’Hebron. Barcelona" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología. Hospital General Universitario Vall d’Hebron. Barcelona" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Trasplante Hepático. Hospital General Universitario Vall d’Hebron. Barcelona" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Anestesia. Hospital General Universitario Vall d’Hebron. Barcelona" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio Medicina Intensiva. Hospital General Universitario Vall d’Hebron. Barcelona" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Servicio de Cirugía Torácica. Hospital General Universitario Vall d’Hebron. P.° Vall d’Hebron. 119-129. 08037 Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Sequential double-lung transplantation. Technique and results in the first three cases" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los pacientes que padecen una enfermedad pulmonar en fase avanzada, asociada a infección respiratoria, en los que se considere la posibilidad de un trasplante, necesitan la sustitución de ambos pulmones. Este procedimiento se venía realizando hasta hace poco, bien mediante un trasplante en bloque corazón-pulmón, cosa poco razonable si el corazón está sano, o mediante un trasplante doble pulmonar, que requiere circulación extracorpórea, y con un alto porcentaje de complicaciones a nivel de la anastomosis traqueal. En 1990 se publicaron los primeros casos de trasplante bipulmonar secuencial que simplificaba la realización de este procedimiento. Después de una corta experiencia, con buenos resultados, en el trasplante pulmonar unilateral, presentamos los tres primeros casos de trasplante bipulmonar secuencial realizados en nuestro país. Se describe la técnica que implica la sustitución consecutiva de ambos pulmones y evita la circulación extracorpórea en la mayoría de casos. El trasplante bipulmonar secuencial reúne las ventajas del trasplante unipulmonar y el tipo de incisión, toracoesternotomía anterior y proporciona un buen acceso a ambas cavidades pleurales facilitando la intervención en los casos que presentan adherencias pleurales.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Patients who suffer advanced lung disease associated to respiratory infection and who are candidates for transplanta tion must have both lungs replaced. Until recently, this proce dure was accomplished by transplanting a heart-lung block, a procedure of questionable merit if the heart is healthy, or by carrying out a double-lung transplant requiring extracorporeal circulation and involving a high percentage of complications the tracheal anastomosis. The year 1990 saw publication of the first descriptions of a simpler procedure, sequential double-lung transplantation. After brief experience with good results in single-lung transplantation, we present the first three cases of sequential double-lung replacement carried out in Spain. We describe the consecutive substitution of both lungs, with no need for extracorporeal circulation in most cases. Sequential bilateral lung transplantation combines the advantages of single-lung transplantation with the use of anterior thoracoesternotomy to provide good access to both pleural cavities, facilitating the procedure when pleural adhesion is present.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Grupo de Trasplante Pulmonar: Servicio de Cirugía Torácica (Dr. J. Teixidor Dr. J. Solé. Dr. P. López de Castro). Servicio de Neumología (Dr. F, Morell. Dr. A. Román. Dra. Montané). Unidad de Trasplante Hepático (Dr. R. Charco). Servicio de Anestesia (Dra. M.<span class="elsevierStyleSup">a</span> L. Comas. Dr. M. Roca. Dra. E. Molina). Unidad de Infecciosas (Dr. J. Gavaldá). Servicio de Rehabilitación (Dr. J.A. García Besada). Servicio de Anatomía Patológica (Dr. J.L. Lirola). Servicio de Bioquímica (Dr. L. Pou). Enfermería (Sra. M. Mir).</p>" "identificador" => "fn0005" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Technique of successful clinical double-lung transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G.A. Patterson" 1 => "J.D. Cooper" 2 => "B. 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Astudillo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin" "fecha" => "1993" "volumen" => "100" "paginaInicial" => "380" "paginaFinal" => "383" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000003000000007/v1_201509151234/S0300289615310450/v1_201509151234/es/main.assets" "Apartado" => array:4 [ "identificador" => "9277" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000003000000007/v1_201509151234/S0300289615310450/v1_201509151234/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615310450?idApp=UINPBA00003Z" ]
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