title: Chylothorax: report of a case complicating orthotopic heart transplantation.
abstract: We describe a case of a chylothorax that occurred in a 62-year-old man after orthotopic heart transplantation. Injury to collateral lymphatics in the anterior mediastinal or thymic areas was the probable cause of the chylous fistula. Excessive chyle drainage causes loss of large amounts of fat, protein, electrolytes, and lymphocytes. These losses further compromise the nutritional and immunologic status of the transplant patient. Conservative therapy with chest tube drainage and a strict medium-chain triglyceride diet allowed the chylous fistula to spontaneously close without the need for surgical intervention.
authors.affiliation: Cardiac Transplant Service, Tampa General Hospital, Fla.
authors.forename: R E
authors.initials: RE
authors.lastname: Bowerman
authors.forename: D A
authors.initials: DA
authors.lastname: Solomon
authors.forename: D
authors.initials: D
authors.lastname: Bognolo
authors.forename: L R
authors.initials: LR
authors.lastname: Brauner
mesh_terms: D015505:Chest Tubes; D002916:Chylothorax / Q000209:etiology* / Q000628:therapy; D004322:Drainage / Q000379:methods; D004750:Enteral Nutrition; D005526:Food, Formulated; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008208:Lymphatic System / Q000293:injuries*; D008297:Male; D008875:Middle Aged