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Right arrow Lung - transplantation

J Thorac Cardiovasc Surg 2006;131:746-747
© 2006 The American Association for Thoracic Surgery

Brief Communication

Pulmonary artery thrombosis caused by hyperinflation of the native lung six years after single lung transplantation for emphysema

Alessandro Baisi, MD * , Mario Nosotti, MD, Ugo Cioffi, MD, PhD, Matilde De Simone, MD, PhD, Lorenzo Rosso, MD, Alessandro Palleschi, MD, Barbara Chella, MD, PhD, Luigi Santambrogio, MD

University of Milan, Department of Surgery—Thoracic Unit, Ospedale Maggiore Policlinico, Fondazione IRCCS, Milan, Italy

Received for publication June 29, 2005; revisions received September 14, 2005; accepted for publication October 7, 2005.

* Address for reprints: Alessandro Baisi, MD, Department of Surgery—Thoracic Unit, Ospedale Maggiore Policlinico, Fondazione IRCCS, Via F. Sforza 35, 20122 Milano, Italy (Email: alessandro.baisi@unimi.it).

The first 20% of the full text of this article appears below.

Hyperinflation of the native lung is a widely known complication after single lung transplantation for emphysema. 1,2 Go This may be verified a few months or a few years after the transplant. 3 Go We report the case of a patient in whom hyperinflation of the native lung was first the cause of chronic respiratory insufficiency for compression of the transplanted lung and then of acute respiratory insufficiency because of pulmonary artery thrombosis.

Clinical Summary

A 49-year-old, former heavy smoker, oxygen-dependent patient underwent a left single lung transplant for emphysema in February 1999. The postoperative course was uneventful. Long-term immunosuppression was maintained with a regimen of cyclosporine (INN: ciclosporin), azathioprine, and steroids. Three months later the patient's respiratory function was excellent (forced expiratory volume in 1 second [FEV1] = 58%, PO 2 = 87 mm Hg, PCO 2 = 37.9 mm Hg), and he returned to work and a normal lifestyle. One year after the transplant a decrease in FEV1 (26% of the best postoperative value) was recorded. Results of a bronchoscopic study were negative for anastomotic stenosis. Viral and bacterial infections were . . . [Full Text of this Article]




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