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J Thorac Cardiovasc Surg 2001;121:981-982
© 2001 The American Association for Thoracic Surgery

Brief Communications

Aerosolized prostacyclin (epoprostenol) as an alternative to inhaled nitric oxide for patients with reperfusion injury after lung transplantation

From the Department of Thoracic and Cardiovascular Surgery, University of Virginia Health Sciences Center, Charlottesville, Va.

Received for publication March 9, 2001. Accepted for publication March 14, 2001. Address for reprints: Curtis G. Tribble, MD, Department of Thoracic and Cardiovascular Surgery, University of Virginia Health Sciences Center, Box 3111, MR4 Building, Charlottesville, VA 22908 (E-mail: cgtuva@aol.com).

Treatment options for patients with severe reperfusion injury after lung transplantation often include the use of inhaled nitric oxide. However, the recent escalation in cost has made its use somewhat prohibitive. Here we describe the technique of using inhaled prostacyclin (epoprostenol), as opposed to using inhaled nitric oxide, for the treatment of lung transplant reperfusion injury. We believe this is the first reported case of its use in this setting.

Clinical summary

A 51-year-old man underwent single lung transplantation for chronic obstructive pulmonary disease. Severe reperfusion injury subsequently developed, with an oxygenation index of greater than 30. ¹ The chest radiograph showed almost complete white-out of the transplanted lung. Mean pulmonary artery pressures preoperatively were 24 mm Hg. Mean pulmonary artery pressures after lung transplantation were 35 to 40 mm Hg. This patient was subsequently treated by arteriovenous extracorporeal membrane oxygenation (ECMO). After the start of ECMO, mean pulmonary artery pressures . . . [Full Text of this Article]

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