Proceedings of the World Society of Cardiovascular and Thoracic Surgeons 29th Annual Congress, Sofia, Bulgaria, 2019
Journal of Cardiothoracic Surgery
Acute renal dysfunction post lung transplant is one of the morbidities encountered that will impact the outcome and costs of both hospitalisation and community care. This is a retrospective study analysing 51 cases of sequential bilateral lung transplant over the last 3 years. As primary variables we analysed pre and post-operative eGFR, ischaemic time, bypass time, intra/post-operative blood products, inotropic support peri -operatively, CVVH required, haemodialysis on discharge, duration of
... arge, duration of postoperative ventilation, length of stay in intensive care unit, return to theatre. Secondary variables analysed were bilateral lung transplant, and comorbidities. There were 29 patients who developed post-operative renal impairment, (57%) out of which 18 patients required CVVH within the first week of ITU stay. Out of these patients, there were 7 patients who were discharge to the ward on haemodialysis. Out of the 29 patients who developed post-operative renal impairment (eGFR<60), only 4 patient had pre-operative renal impairment (eGFR <60). Out of the 7 patients discharged to the ward on dialysis, 6 patients required post-operative inotropes, only one pre-operative inotropes and 6 patients required intraoperative blood products. 18 patients requiring CVVH post-transplant had a median bypass time of 300 mins and an ischaemic time of 350 mins. Out of the 18 CVVH patients, 17 patients required blood transfusion intraoperatively and 15 patients post-operatively. Out of the CVVH patients 15 patients had a prolonged ventilation (>1 day). A prolonged ischaemic time, as well as a prolonged operative time, mainly due to bilateral lung transplantation, as well as usage of blood products intra-operatively and inotropic support post operatively seems to be associated with a high incidence of renal impairment post sequential bilateral lung transplantation. O3 Background Although surgery has had a high level of morbidity and mortality, it is the more preferable treatment for this disease; an issue that is still controversial. Materials and Methods: In a descriptive study, 30 patients with pulmonary Aspergilloma who were treated via surgery, were examined retrospectively. In this study, the patients were examined based on their age, sex, presurgery clinical symptoms, the injured part, the method of surgery and the post-surgery problems. Results These patients include 21 men and 9 women with the average age of 48.13. The most common symptom was hemoptysis (90%), the cough with sputum and drug-resistant pneumonia were also seen. The most common problematic parts include LUL and RUL. The surgery was carried out on 21 patients by lobectomy and 9 patients (30 %) by segmentectomy. After the surgery, residual space, wound infection, Bronchopleural fistula were seen respectively in 5 cases (16.7%), 3 cases (10%), and 2 cases (6.7%). The mortality rate was 1 person. Conclusions In comparison of the method of surgery in treatment of pulmonary Aspergilloma (lobectomy and segmentectomy) and the sex, clinical symptoms, post-surgery side effects and mortality, no meaningful relationship was seen. As a result, these methods of surgery are successful.