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Irving L. Kron
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Right arrow Lung - transplantation

J Thorac Cardiovasc Surg 2001;122:1257-1258
© 2001 The American Association for Thoracic Surgery

Brief Communications

Donor lung salvage after neurogenic pulmonary edema with the use of post-transplant extracorporeal membrane oxygenation

Steven M. Fiser, MD, Irving L. Kron, MD, Stewart M. Long, MD, Aditya K. Kaza, MD, Mark Robbins, MD, John A. Kern, MD, Curtis G. Tribble, MD Charlottesville, Va

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

Received for publication March 16, 2001. Accepted for publication April 12, 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: ctribble@ virginia.edu).

Development of neurogenic pulmonary edema can prevent the use of donor lungs for transplantation. We present a case in which severe preoperative donor neurogenic pulmonary edema was overcome after transplantation with the use of extracorporeal membrane oxygenation.

Clinical summary

Donor
A 17-year-old child was pronounced dead after a gunshot wound to the head. Soon after consent for organ donation had been obtained from the family, significantly worsening oxygenation was noted despite diuretics and pulmonary therapy (Table 1). The initial trauma chest x-ray film was clear; however, a follow-up chest x-ray film was consistent with the development of severe pulmonary edema in both lungs. During this period, the mean blood pressure was at least 65 mm Hg, extensive fluid resuscitation was not necessary, and a drug screen was negative. Thus, it was believed that the donor's pulmonary edema was neurogenic in origin.


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  		Table 1. Donor management
 
Recipient
A 55-year-old woman had severe pulmonary fibrosis: forced expiratory volume in 1 second of 0.71 L and forced vital capacity of 0.85 L, 33% and 30% of predicted, respectively; room air blood gas pH, 7.40; PCO2, 48 mm . . . [Full Text of this Article]




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