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Marriott AJ, Hwang NC, Lai FO, Tan CK, Tan YM, Lim CH, Boey SK, Tay SM, Cheow PC, Lim YP, Chan T, Loh K, Kwok B, Chung A, Sivathasan C
Correspondence: A/Prof Hwang Nian Chih, email@example.com
We report a case of combined heart and liver transplantation for familial amyloid polyneuropathy. This is the first such combined transplant performed in Asia, and differs from previously described cases, in that cardiopulmonary bypass was continued at partial flow during liver transplantation in our case. This was done in order to provide haemodynamic support to the cardiac graft and to protect it from the impending reperfusion insult that frequently accompanies liver transplantation. The utility of this management course is discussed, along with its actual and potential complications. We also describe the impact of a lung-protective ventilation strategy employed during cardiac transplantation.
Keywords: cardiopulmonary bypass, familial amyloid polyneuropathy, heart transplantation, liver transplantation, reperfusion injury
Singapore Med J 2011; 52(3): e48-e51