Master Huo's voice was very weak, but every word pierced Li Xiyang's heart like a spike.

"I... It's hopeless... But... Xiaoxiao... Can't live without Mom. ”

"Medical... Doctor... Please... Help... I..."

After speaking, Master Huo opened his mouth and spit out a mouthful of blood, and his whole head slammed on the bed.

[Brain: The owner automatically gives up the chance to survive, and all organs except the cardiopulmonary system will be shut down one after another...]

[Thank you brothers, decades of sincere cooperation...]

[The rivers and lakes are far away, we will have no time in the future...]

Seeing the dialogue of the organs, Li Xiyang was stunned.

He had never seen a patient so resolute in his determination to die.

That's when the phone rang again.

"Daddy, Daddy..."

"Husband, how are you, can you hear me..."

On the other end of the phone, the mother and daughter cried in grief and panic.

"Dad, you speak, Xiaoxiao will be here soon..."

"Husband, you can't leave us behind, you must hold on..."

On the hospital bed, Master Huo miraculously moved again.

He tried hard to open his eyes, but he was tired and weak.

"Old... Wife, to... I can't accompany you anymore, right... I can't afford it..."

"Photo... Take care of... Myself... Still... There is Xiaoxiao..."

"What nonsense are you talking about, you said that you would take care of me and Xiaoxiao for the rest of your life, you can't talk and don't count..."

"Husband, you speak."

"Husband, what's wrong with you..."

"Daddy, Daddy..."

On the other end of the phone, Zheng Xiaoyu shouted, "Doctor Li, how is Master Huo?!" ”

After a moment of silence, Li Xiyang's hoarse voice sounded, "I'll drag you to come!" ”

He didn't directly say anything about Master Huo's situation, but this sentence made everyone's hearts fall to the bottom.

"Husband..."

The woman covered her mouth with her hands, her heart aching so much that she couldn't breathe.

"Daddy..."

Xiaoxiao's tears fell down big and big.

"Damn!"

Zheng Xiaoyu gritted his teeth, and then kicked the accelerator directly through a red light.

Five minutes later,

"It's here, get out of the car."

Zheng Xiaoyu took Xiaoxiao's mother and daughter through the emergency hall and went straight to the No. 3 emergency room.

As soon as the door opened, I saw Li Xiyang kneeling on the hospital bed desperately doing cardiopulmonary resuscitation.

And under him, Master Huo's whole body was already soaked in blood.

It is not an exaggeration to say that he is a bloody man.

Seeing the three people coming in, Li Xiyang still didn't stop the movements of his hands.

At least... Let them say goodbye!

！

"Husband..."

"Daddy..."

Xiaoxiao and her mother couldn't believe their eyes and ran frantically towards the hospital bed.

"Husband, wake up, I'm here, Xiaoxiao is also here, open your eyes and look at us!"

"Dad, don't sleep, Xiaoxiao is afraid..."

Finally, the man groaned and moved his fingers twice.

Li Xiyang stopped cardiopulmonary resuscitation and rolled over and got out of bed.

Then tell the mother and daughter about Master Huo's will.

The woman broke down and cried, "Huo Mingyuan, you conscienceless thing, who wants your lungs, who wants your lungs!"

”

"You're gone, how am I going to live!

”

"I don't want anything, I just want you to live well!

”

The woman's screams and cries are heart-wrenching.

"Old... Wife..."

Master Huo moved his fingers and spoke with difficulty.

"Husband, you're awake, it's great!"

"Dad, I'm Xiaoxiao!"

Xiaoxiao ignored her father's blood, and pounced directly with tears in her eyes.

At this moment, Master Huo's eyes couldn't be opened, and the sticky blood seemed to be sticking to his eyelids.

"Wife, answer... Respond to me, live well, live well... Take care of Xiaoxiao to grow up..."

"Dad, look, Xiaoxiao's teeth fell out, didn't you say that you want to throw Xiaoxiao's teeth on the roof together, you get better quickly, let's throw them together..."

Xiaoxiao kept wiping her tears, still holding a tooth in her hand.

She got it off when she was eating candy tonight, and secretly hid it to surprise him when her dad came home from work.

"Woo woo, Dad, look at it!"

Master Huo moved his fingers with difficulty, and Xiaoxiao hurriedly put his teeth on his father's hand.

Slowly close your palms together and hold your teeth in the palms of your hands.

A satisfied smile appeared on Master Huo's face.

"Aka... Xiao, I've grown up..."

After saying that, the ECG stopped working.

"Time of death, 22:03!"

Li Xiyang's deep voice sounded in the rescue room.

"No, no, husband, you're going to die, you're going to leave us..."

"Dad, don't sleep, wake up and see Xiaoxiao..."

The mother and daughter lay on Master Huo and cried bitterly.

……

Emergency Department Conference Room.

Zhao Hai, Zhang Jie, Zheng Xiaoyu, Li Xiyang, and even Huang Ping hurried back.

Five people sat in the room, and the atmosphere was oppressive and dreary.

First of all, Zhang Jie spoke, "Needless to say, the difficulty of lung transplantation is even more dangerous, and I suggest that thoracic surgery, respiratory and other related departments be combined in place." ”

Huang Ping shook his head and sighed, "The thoracic surgery department has been disbanded in the afternoon, and those people in the respiratory department can't do this kind of surgery at all!" ”

Zhao Hai also said, "We have only done 7 lung transplants in Renhe for so many years, and 4 of them have failed, and the operation is too difficult!" ”

As soon as Zhao Hai opened his mouth, everyone realized the seriousness.

According to statistics, nearly 3,000 lung transplants are completed in the world every year, and only 100 cases can be done by domestic doctors!

This is a good example of the difficulty of lung transplantation.

Lung transplantation is the top thoracic surgery.

In 1963, Dr. James Hardy of the University of Mississippi in the United States performed the world's first human lung transplant.

However, in the following 30 years, only about 40 attempts were made, but none of them were successful.

It was not until the 90s that the Toronto General Hospital in Canada successfully performed a single lung transplant for a patient with pulmonary fibrosis, and the patient survived for six and a half years, which was the beginning of modern lung transplantation.

The relative stagnation of 30 years shows the difficulty of the early stage of lung transplant exploration.

In fact, the physical factors of the transplant patient and the timing of the surgery are very important.

In the case of domestic patients, lung transplantation is usually considered at a very advanced stage.

As a result, the best timing is missed.

The second is that compared with other organs, lung tissue is more susceptible to damage, and in lung donors who die from trauma and other reasons, it is often accompanied by pulmonary contusion, aspiration, infection, acute respiratory distress syndrome and other injuries.

Neuronal pulmonary edema can also occur after brain death, so the utilization rate of the donor lung is not high, only 1/5 of the utilization rate of the kidney.

Therefore, how to expand the source of donor lungs and improve the utilization rate of donor lungs has become the most urgent problem to be solved in the field of lung transplantation in the world.

In addition, the ischemic time requirement for the donor is very short.

Donors have high requirements in the pre-transplant maintenance process, which has a certain deviation from the maintenance strategies of other transplanted organs.

The ischemia time requirement for lung transplantation is shorter, the shelf life is only six hours, and the longer ischemia time will lead to a decrease in the quality of the donor lungs, which in turn will affect the effect of lung transplantation.

Then there are the intraoperative and postoperative infectious factors, unlike other organ transplants, after heart, kidney, and liver transplantation, these transplanted organs are all internal organs, within the blood circulation and overall immune protection,

After lung transplantation, the donor lung is directly connected to the atmosphere, and the microorganisms from the outside world and the customized microorganisms of the donor lung itself increase the chance of infection in the transplanted lung.

At the same time, due to the effect of immunosuppressants, it also increases the risk of lung infections, including bacterial and fungal infections in the lungs.

In conclusion, intractable infections in a low immune state during transplantation have brought great challenges to the survival of patients.

Finally, the difficulty of the operation itself is very large.

Doctors with lung transplant qualifications are required to do this, but such doctors are very rare in the country.

Because the heart and lungs are connected, many patients have lung failure that causes heart function at the same time.

Therefore, every lung transplant surgeon must be a top thoracic specialist.

In conclusion, lung transplantation is arguably the most difficult and risky of all organ transplants.

Zhao Hai added, "Xiaoxiao's mother has suffered a huge mental impact, which will inevitably lead to further deterioration of the patient, you look at her CT, the hilar fibrosis and calcification are extremely serious, and the whole lung is almost stuck to the chest wall." ”

None of us can do that.

Let's help her transfer to the hospital,

"At least... You can't let Master Huo die in vain! ”

Zheng Xiaoyu's body trembled,

She is sad and sad, she is unwilling,

But Zhao Hai is right, lung transplantation is really not that simple, and it must not live up to Master Huo's last belief.

Or?

"Leave it to the Third Academy!"

It is said that the three hospitals completed 20 lung transplants in the first half of the year alone, and handed them over to Xiaoxiao and her mother to have hope.

Everyone looked at each other and nodded.

Although each can see the helplessness and sadness in each other's eyes.

After all, there is nothing sadder than handing over a patient to another hospital.

And it's a patient who knows them so well and trusts them so much.

But

After all, it is still necessary to consider the safety of the patient's life.

"That's it, I'll talk to the patient!"

Huang Ping, as the oldest doctor in the emergency department, also took the initiative to take this tricky job on himself.

At this moment,

A voice sounded in the room,

"I don't need to transfer to the hospital, I can do this surgery!"

Everyone looked at Li Xiyang, who had never spoken.

For a while, everyone's eyes were focused on Li Xiyang.

Zhao Hai frowned, "Doctor Li, I've heard about your skills, but this is an extremely difficult lung transplant operation." ”

Even experts in the field of heart and lungs dare not say that they can be 100% successful!

Are you sure you can do it?

Li Xiyang nodded, and said with a serious gaze, "I won't joke about my profession, let alone the lives of patients!" ”

"But..."

Zhao Hai also wanted to say more, but Li Xiyang interrupted directly, "The lung is different from solid organs such as liver and kidney, it is a hollow viscera, and the safest cold ischemia storage time limit is only 4 hours.

It is also prone to severe ischemia-reperfusion injury, which may lead to early transplant pulmonary edema and even loss of lung function.

Have you calculated how long it will take to get from Renhe to Sanyuan?

How long does it take to prepare for surgery?

Can you be sure that there is no secondary damage to the lung source during this process? ”

Zhao Hai was speechless.

Master Huo originally died in a car accident, and his lungs were difficult to protect himself from damage, and if the road was delayed, it was likely that he would not have waited for the Third Hospital, and his lung function would have been lost.

Li Xiyang said in a deep voice, "This is Master Huo's last will, I'll help him complete it!" ”

As soon as these words fell, Zheng Xiaoyu immediately said, "Doctor Li, I believe in you!" ”

Huang Ping and the three of them glanced at each other, and they all nodded.

"Then please Dr. Lee."

"Dr. Li, do you need any special equipment?"

Li Xiyang thought for a while and said quickly, "Use 40% formalin fumigation air to disinfect two operating rooms, one for trimming the donor lungs, and one for lung transplantation.

In addition to a set of conventional lobectomy instruments and dressings, prepare another set of shaved ice equipment for shaved ice when repairing the donor lung.

6 boxes of sterile ice cubes. Hold 1000 ml of normal saline in an aluminum box with a lid, wrap it with a sterile cloth and put it in the refrigerator for freezing.

15 bottles of normal saline at 4 °C, 500 ml each,

4/0 Prolene 20 with double needle,

2 aortic occlusion forceps,

4 sidewall pliers,

1 set of extracorporeal bypass intubation instruments,

1 defibrillator,

……”

As Li Xiyang quickly said the names of the devices one after another, several people could not hide the shock in each other's eyes.

At first, they thought that Li Xiyang was acting rashly, but now it seems that he may really be able to do it.

Zhang Jie excitedly quickly wrote down one device after another, not daring to omit anything.

"Dr. Li, do you need anything else?"

Li Xiyang nodded, but this thing may not be available in ordinary hospitals.

"What is it?"

“ECMO！”

ECMO, also known as extracorporeal membrane oxygenation, is known as a lifesaver for heart-lung transplantation.

After Li Xiyang finished speaking, he looked at the few people opposite and laughed.

"Dr. Li, don't worry, we have this ECMO in the emergency department!"

"Oh?"

Li Xiyang was stunned for a moment.

In a sense, extracorporeal membrane oxygenation represents a technology for the critical care level of a hospital, or even a region or a country.

Only a few super-first-class hospitals in China have them.

Zheng Xiaoyu saw Li Xiyang's doubts and said with a smile, "Doctor Li, don't you know who our current boss Renhe is?" ”

Li Xiyang was stunned for a moment, and then reacted quickly.

Pioneer Company made its fortune by selling medical equipment, how could his hospital have less equipment.

Although the current Renhe is a little miserable in terms of staffing, if the equipment is said to be the second in the imperial capital, no one dares to say that it is the first.

The core parts of extracorporeal membrane oxygenation are the membrane lungs (artificial lungs) and blood pumps (artificial heart),

It can provide long-term cardiopulmonary support for patients with severe cardiopulmonary failure, and win valuable time for the rescue of critical illness.

Its principle is to draw venous blood out of the body, and inject it into the patient's artery or venous system after oxygenation by artificial heart-lung bypass with special materials, which plays a part of the heart-lung replacement role and maintains the oxygenated blood supply of human organs and tissues.

Good

With extracorporeal membrane oxygenation, this surgery is half the battle!

"Dr. Li, do you have a specific surgical plan?"

Li Xiyang nodded and said, "I'm going to have a sequential double lung transplant!" ”

Typically, there are 5 types of lung transplants.

First, combined heart-lung transplantation refers to the replacement of both heart and lungs at one time, and the airway can be anastomosed at the trachea, or the bilateral bronchial tubes can be anastomosed separately.

Second, whole bilateral lung transplantation, in the cardiopulmonary bypass, bilateral lung tissue is cut from the trachea, and then the lung is transplanted, but it is generally used for children's surgery, and adults are not commonly used.

Third, single-lung transplantation, which is the most commonly used lung transplantation method now, but most of them do not use cardiopulmonary bypass.

Fourth, lung lobe or reduced lung transplantation generally refers to the transplantation of living lobes of the lungs to children by parents or relatives and friends, and the lungs of brain-dead people can also be donated.

Finally, there is the sequential bilateral lung transplant, which is essentially two single lung transplants for the same patient at a time.

This procedure can reduce airway complications and reduce the likelihood of postoperative infection.

Huang Ping's eyes lit up, "The Imperial Capital Lung Transplant Center seems to use this technique!" ”

Li Xiyang nodded, "This surgical method is currently the most commonly used and the most mature surgical method for bilateral lung transplantation.

Everyone was more convinced of Li Xiyang.

But

"Are you going to do two surgeries at the same time?"

Typically, two teams of surgeons are responsible for the operation of the lung-derived donor and the recipient.

Because any one operation may take more than ten hours.

If you come one by one, the lung source is most likely inactivated.

Li Xiyang asked Huang Ping and the others, "Can you do it?" ”

The four of them looked at each other, all smiling bitterly.

They hadn't done it before.

Besides, there are organ transplants that will be handed over to the emergency department!

Li Xiyang frowned slightly, Master Huo was seriously injured in the aorta because of a car accident, and there was more intrathoracic bleeding.

Time was pressing, and they didn't have time to take a closer look at the lung damage.

But to say that there is no at all, it is obviously impossible.

In this case, the time given to him is even more urgent.

But Xiaoxiao's mother's situation is even worse, once she misses this opportunity, she may not be able to wait for the next lung source.

"In this case, I will do the removal of the donor lung, and Dr. Zheng is responsible for the emergency chest opening of Xiaoxiao's mother, and do nothing else, and then perform the patient's lung removal operation when I arrive."

Dr. Zheng nodded, "I'm fine, but can you do it alone?" ”

Two surgeries in a row was a great physical test.

And a few people don't know that Li Xiyang has just completed a very difficult amputated limb replantation.

Otherwise, I would never dare to let Li Xiyang harden.

……

Soon, Master Huo's body was pushed into the operating room.

Xiaoxiao's mother's psychological work has also been done by Zheng Xiaoyu and several nurses.

She agreed to undergo a retransplant because it was her husband's last obsession.

At the same time, she wants to live more than anyone else, because there is still Xiaoxiao, and she has to be strong no matter what.

Then Zheng Xiaoyu accompanied Xiaoxiao's mother to have a cardiac catheterization and coronary angiography, and then was pushed into the operating room next door.

Huang Ping and the three of them also entered the operating room, each busy with preoperative preparations.

Li Xiyang stood in front of the window of the operating area and quietly looked at the emergency hall.

It was late at night, there was no one in the corridor of the hospital, and a little girl of four or five years old was sitting alone in a chair, her eyes swollen from crying.

The small bodies curled up together, their helpless eyes full of fear and sadness.

She's still so young, she shouldn't be treated like this by fate.

Clutching the candy in his palm, Li Xiyang turned around and walked into the operating room.