title: Donor-acquired fat embolism syndrome after lung transplantation.
abstract: OBJECTIVE
  Fat embolism is a known complication of severe trauma and closed chest cardiac resuscitation both of which are more common in the lung transplant donor population and can lead to donor-acquired fat embolism syndrome (DAFES). The objective was to review the diagnosis and management of DAFES in the lung transplantation literature and at our centre.
  
  
  METHODS
  We performed a literature review on DAFES using the Medline database. We then reviewed the transplant record of Brigham and Women's Hospital, a large academic hospital with an active lung transplant programme, for cases of DAFES.
  
  
  RESULTS
  We identified 2 cases of DAFES in our centre, one of which required extracorporeal membrane oxygenation (ECMO) for successful management. In contrast to the broader literature on DAFES, which emphasizes unsuccessfully treated cases, both patients survived.
  
  
  CONCLUSIONS
  DAFES is a rare but likely underappreciated early complication of lung transplant as it can mimic primary graft dysfunction. Aggressive interventions, including ECMO, may be necessary to achieve a good clinical outcome following DAFES.
authors.affiliation: Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Jacob
authors.affiliation: Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Courtwright
authors.affiliation: Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Souheil
authors.initials: S
authors.lastname: El-Chemaly
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Emilian
authors.initials: E
authors.lastname: Racila
authors.affiliation: Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Divo
authors.affiliation: Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Burkett
authors.affiliation: Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Fuhlbrigge
authors.affiliation: Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Hilary J
authors.initials: HJ
authors.lastname: Goldberg
authors.affiliation: Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA irosas@rics.bwh.harvard.edu.
authors.forename: Ivan O
authors.initials: IO
authors.lastname: Rosas
authors.affiliation: Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Camp
mesh_terms: D000328:Adult; D004620:Embolism, Fat / Q000209:etiology*; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000209:etiology*; D014019:Tissue Donors; D019737:Transplants / Q000503:physiopathology*
keywords: Extracorporeal membrane oxygenation; Fat embolism; Graft dysfunction; Lung transplantation; Survival