Single-lung transplantation in a patient with cystic fibrosis and an asymmetric thorax.
We report metachronous single-lung transplantation for cystic fibrosis after contralateral pneumonectomy. Kyphoscoliosis and mediastinal shift required careful donor-lung sizing with computed tomography and was not dependent on typical parameters. Severe reperfusion injury was treated with nitric oxide, C1-esterase inhibitor, and continuous venovenous hemodialysis. The patient was extubated on the fifth postoperative day and is alive and well. We conclude that single-lung transplantation after contralateral pneumonectomy for patients with cystic fibrosis and an asymmetric chest and evident lung volume mismatch may be an acceptable functional therapeutic option.
Piotrowski
J A
JA
Department of Thoracic and Cardiovascular Surgery, Essen University Medical School, Germany.
Splittgerber
F H
FH
Donovan
T J
TJ
Ratjen
F
F
Zerkowski
H R
HR
D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007738:Kyphosis / Q000150:complications; D016040:Lung Transplantation; D008297:Male; D011013:Pneumonectomy; D015427:Reperfusion Injury / Q000628:therapy; D012600:Scoliosis / Q000150:complications; D013909:Thorax / Q000473:pathology*