小児開心術後の重症肝機能障害に対する交換輸血療法

概要

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We experienced five cases of acute hepatic failure following open-heart surgery congenital heart diseases: two cases of tetralogy of Fallot, one each case of ventricular septal defect with mitral regurgitation, coarctation of the aorta with ventricular septal defect, and transposition of the great arteries. Their ages at operation ranged from two months to five years. The exchange transfusion for acute hepatic failure was performed with 150-200ml/kg of fresh whole blood. After the exchange transfusion, the level of GOT, GPT and LDH decreased significantly. The level of total birilubin. ALP, BUN, and Crdecreased as well, but not significantly. In the results three of five patients survived and two died. We thought that acute hepatic failure following open-heart surgery was not always associated with low cardiac output syndrome and might not have any causes. Postoperative hepatic failure influenced upon hemodynamic state unfavorably. Exchange transfusion for such patients was very effective for not only the improvement of their hepatic function but also the stabilization of their hemodynamic state. We concluded that postoperative hepatic failure occurred within one week after operation, and exchange transfusion was useful for their treatment.
日本小児外科学会の論文
1988-06-20