(Fighting new crown pneumonia) 66-year-old man received new lung transplantation after receiving new lung pneumonia
China News Network, Hangzhou, March 2 (Reporter Zhang Bin and correspondent Wang Rui) The reporter learned from the First Affiliated Hospital of Zhejiang University Medical College (hereinafter referred to as the First Hospital of Zhejiang University) on March 2 that a 66-year-old female from the hospital Patients with neo-coronary pneumonia underwent a lung transplant. More than 30 medical specialists from the First Hospital of Zhejiang University worked together to treat the patient. At present, the vital signs of the patient are stable.
On the afternoon of March 1, the multidisciplinary operation of the First Hospital of Zhejiang University was completed in the negative pressure operating room of the hospital's Zhijiang District.
in surgery. Photo courtesy of Zhejiang University First Hospital
The hospital introduced that the 66-year-old female patient was diagnosed on January 31, and was transferred from a hospital in Zhejiang Province to the First Affiliated Hospital of Zhejiang University for rescue on February 2 due to disease progression. The disease progressed rapidly. Intubation and use of artificial membrane lung (ECMO).
This is a "tug-of-war" with Death. After treatment, the patient's viral nucleic acid test has turned negative for several consecutive days, but the lungs have become severely constrained, the lung function is irreversibly impaired, and life is in a "dead end". The only way to continue life is lung transplantation.
Patients who rely on artificial membrane lungs (ECMOs) to barely sustain their lives are too fragile to survive the slightest risk. Can they survive a lung transplant? The surgical plan was discussed again and again.
An organ transplant expert and Party Secretary of Zhejiang University First Hospital Liang Tingbo led experts from relevant departments of the hospital to conduct multiple multidisciplinary diagnosis and treatment (MDT). During the consultation, the hospital policy repeatedly evaluates the patient's related examination data and formulates a treatment plan. The transplant was finally demonstrated by the large organ transplantation ethics committee of the hospital, and the informed consent of the patient's family was obtained.
The difficulty of the operation is beyond imagination: on the one hand, the respiratory failure of the patient leads to increased pulmonary artery pressure, the right heart increases significantly, the entire heart rotates, increasing the difficulty of the operation, and on the other hand, the body is obese. Although there is no underlying disease itself, due to the small chest cavity, the space and The mismatch in lung size makes the cardiovascular function more fragile than ordinary people. This is not only one of the factors leading to the rapid progress of the disease, but also makes the transplantation operation more complicated.
However, after evaluation by the expert group, the patient was healthy before the illness, and the cardiopulmonary function was normal, mainly due to the rapid deterioration of the disease due to the development of new coronary pneumonia, and the condition met the relevant surgical standards.
To this end, the lung transplantation department, anesthesiology department, operating room, intensive care unit, extracorporeal circulation group, ultrasound and other teams of the First Hospital of Zhejiang University have fully prepared for this surgery that may come at any time, staffing is in place, and all have received protective training and Assessment to ensure the safety of medical staff. From the transfer route to the handover of the patient, from the surgical procedure to the operating standard, the hospital has detailed each step, and even some key nodes are accurate to the second. On the other hand, the Zhejiang University First Hospital team searched for possible matching donors nationwide to win time for saving lives.
On the morning of the 1st, a Hunan brain death patient donated great love, the lungs were matched with the patient successfully, and the operation entered the countdown. At 10:30 on March 1st, the donor completed the donation. At 13:05, the doctors and nurses involved in the operation performed a full set of protective measures. Wearing a positive pressure headgear, Han Weili, director of the Department of Lung Transplantation, Zhejiang University First Hospital, performed lung transplantation under ECMO. Surgery officially started; at 15:56, the aircraft for lungs landed in Hangzhou; at 17:00, the lungs arrived at the operating room of the Zhijiang Hospital, and the doctor immediately started repairing; at 21:18, both lungs were successfully transplanted.
Comparison of patients' lungs before and after surgery. Photo courtesy of Zhejiang University First Hospital
The medical staff present was too late to celebrate, and immediately returned to the new round of fighting. Since patients also face problems such as respiratory function effects caused by obesity, they must be closely monitored at all times. Intensive care experts have long been waiting at the transfer point, escorting patients to the monitoring room safely, and the relay of life continues.
According to Han Weili, the entire surgical process is dangerous, especially the left atrial sleeve anastomosis of the pulmonary veins is particularly difficult to handle. With a little care, either the left atrium cannot be anastomosed or the forceps slippage is blocked, which directly leads to death. "Fortunately, the team has rich experience and cooperation, and the problems are resolved one by one."
It is reported that since the outbreak of new crown pneumonia, Zhejiang University First Hospital, as the designated hospital for new crown pneumonia diagnosis and treatment in Zhejiang Province, has admitted 104 confirmed cases, critically ill and severe patients accounted for 75% of the total number of cases. Of the critically ill patients currently rescued in the hospital, 11 rely on ECMO to maintain their lives. Previously, the first 35-week-old neonatal pneumonia patient in Zhejiang Province also gave birth to a healthy baby "small dumplings" here, and they have all been discharged. (Finish)