The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2023 Aug 09
Mechanical thrombectomy for acute pulmonary embolism in lung transplant recipients.
ABSTRACT
The rates of pulmonary embolism (PE) are high among lung transplant (LT) recipients. Management is challenging because of elevated bleeding risks and inadequacy of conventional PE risk stratification tools. New percutaneous large bore mechanical thrombectomy catheters are being increasingly used effectively to debulk thrombus and restore flow immediately. We describe the use of mechanical thrombectomy (MT) in 8 LT recipients. All patients were diagnosed with intermediate/high-risk proximal PE involving the allograft and underwent successful MT within 30 hours of diagnosis. Estimated blood loss was between 200 and 450 cc, with 3 patients requiring blood transfusions. Improvement in heart rate and oxygenation was seen in all 8 patients after the procedure. In the 30 days after MT, 7 of 8 patients survived. One patient died from major bleeding occurred 16 days after MT and 5 days after venoarterial extracorporeal membrane oxygenator decannulation. Mechanical thrombectomy may provide a feasible management strategy in select LT recipients with pulmonary embolism.
New answer by at CWRU School of Medicine (September 23, 2024)
The occurrence of pulmonary embolism after a lung transplant is well-reported (Kahan et al., PMID 17403474). Consequences of large PE can include immediate life-threatening ci...