Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome

Background: Lung transplantation is recognized as the only therapeutic option for patients who develop irreversible pulmonary fibrosis after herbicide intoxication.Methods: We have collected and presented clinical course and outcome of four patients who received lung transplantation due to paraquat...

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Autores principales:	Guohui Jiao, Xiangnan Li, Bo Wu, Hang Yang, Guoqing Zhang, Zheng Ding, Gaofeng Zhao, Jingyu Chen
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	herbicide pulmonary fibrosis lung transplantation ECMO hemopurification Surgery RD1-811
Acceso en línea:	https://doaj.org/article/1d0deb9d7ee541ba821e6f1d16ec1abc
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spelling	oai:doaj.org-article:1d0deb9d7ee541ba821e6f1d16ec1abc2021-12-01T04:44:07ZCase Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome2296-875X10.3389/fsurg.2021.754816https://doaj.org/article/1d0deb9d7ee541ba821e6f1d16ec1abc2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.754816/fullhttps://doaj.org/toc/2296-875XBackground: Lung transplantation is recognized as the only therapeutic option for patients who develop irreversible pulmonary fibrosis after herbicide intoxication.Methods: We have collected and presented clinical course and outcome of four patients who received lung transplantation due to paraquat and diquat intoxication from 2018 to 2021. Another patient who received initial lung transplantation due to paraquat intoxication and re-transplantation due to chronic lung allograft dysfunction in 2019, was further reported. Patients were admitted in lung transplantation centers, including the 1st affiliated hospital of Zhengzhou University and Wuxi Lung transplantation center. Previous reported cases from Europe, Canada and China were also summarized as benchmark.Results: During the period from the year of 2018 to 2021, there have been four patients in China, who received lung transplantation due to herbicide intoxication. Median age of the four patients was 37 (IQR 34.5, 39.75) years old. Median time from intoxication to lung transplantation was 27.5 (IQR 27, 30.5) days. Bilateral lung transplantation was performed in three patients, while one single lung transplantation was performed in an urgent listed patient. Extracorporeal Membrane Oxygenation (ECMO) and hemopurification support were used in all patients (100%). Details of the cases with follow-ups were further presented and analyzed.Conclusions: Late timing of bilateral lung transplantation can be performed successfully for pulmonary fibrosis after paraquat or diquat intoxication. The survival of patients with complex perioperative conditions can be achieved with a multidisciplinary team to manage the irreversible effects of intoxication.Guohui JiaoXiangnan LiBo WuHang YangGuoqing ZhangZheng DingGaofeng ZhaoJingyu ChenFrontiers Media S.A.articleherbicidepulmonary fibrosislung transplantationECMOhemopurificationSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	herbicide pulmonary fibrosis lung transplantation ECMO hemopurification Surgery RD1-811
spellingShingle	herbicide pulmonary fibrosis lung transplantation ECMO hemopurification Surgery RD1-811 Guohui Jiao Xiangnan Li Bo Wu Hang Yang Guoqing Zhang Zheng Ding Gaofeng Zhao Jingyu Chen Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome
description	Background: Lung transplantation is recognized as the only therapeutic option for patients who develop irreversible pulmonary fibrosis after herbicide intoxication.Methods: We have collected and presented clinical course and outcome of four patients who received lung transplantation due to paraquat and diquat intoxication from 2018 to 2021. Another patient who received initial lung transplantation due to paraquat intoxication and re-transplantation due to chronic lung allograft dysfunction in 2019, was further reported. Patients were admitted in lung transplantation centers, including the 1st affiliated hospital of Zhengzhou University and Wuxi Lung transplantation center. Previous reported cases from Europe, Canada and China were also summarized as benchmark.Results: During the period from the year of 2018 to 2021, there have been four patients in China, who received lung transplantation due to herbicide intoxication. Median age of the four patients was 37 (IQR 34.5, 39.75) years old. Median time from intoxication to lung transplantation was 27.5 (IQR 27, 30.5) days. Bilateral lung transplantation was performed in three patients, while one single lung transplantation was performed in an urgent listed patient. Extracorporeal Membrane Oxygenation (ECMO) and hemopurification support were used in all patients (100%). Details of the cases with follow-ups were further presented and analyzed.Conclusions: Late timing of bilateral lung transplantation can be performed successfully for pulmonary fibrosis after paraquat or diquat intoxication. The survival of patients with complex perioperative conditions can be achieved with a multidisciplinary team to manage the irreversible effects of intoxication.
format	article
author	Guohui Jiao Xiangnan Li Bo Wu Hang Yang Guoqing Zhang Zheng Ding Gaofeng Zhao Jingyu Chen
author_facet	Guohui Jiao Xiangnan Li Bo Wu Hang Yang Guoqing Zhang Zheng Ding Gaofeng Zhao Jingyu Chen
author_sort	Guohui Jiao
title	Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome
title_short	Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome
title_full	Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome
title_fullStr	Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome
title_full_unstemmed	Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome
title_sort	case report: delayed lung transplantation with intraoperative ecmo support for herbicide intoxication-related irreversible pulmonary fibrosis: strategy and outcome
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/1d0deb9d7ee541ba821e6f1d16ec1abc
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Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome

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