Lung Torsion After Lung Transplantation

Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part IV: Recipient-Related Risk Factors and Markers

“…Lobar torsion in an appropriately orientated lung has been reported with severe graft dysfunction and subsequent hemorrhagic infarction. [101][102][103] A chest X-ray showing lobar collapse and consolidation and a bronchoscopic examination revealing obstruction of the airway supports the diagnosis. Computed tomographic images can offer further evidence for the torsion.…”

Video-Assisted Thoracoscopic Conservative Repair of Postoperative Lobar Torsion

“…Previous cases have been treated with completion lobectomy of the twisted lobe because of hemorrhagic infarction and gangrene; however, no conservative case, except lung transplant, has been reported [1]. We report successful video-assisted thoracoscopic surgical repair of right middle lobe torsion after upper lobectomy, and we describe the benefits and risks of preserving a twisted lung.…”

“…(Ann Thorac Surg 2014;98:e119-21) Ó 2014 by The Society of Thoracic Surgeons P ostoperative lobar torsion is a rare yet life-threatening complication with a reported prevalence of 0.09% to 0.4% in all pulmonary resection cases [1,2]. Previous cases have been treated with completion lobectomy of the twisted lobe because of hemorrhagic infarction and gangrene; however, no conservative case, except lung transplant, has been reported [1].…”

Lobar torsion after lung transplantation

“…3 Additionally, the size discrepancy commonly encountered in patients undergoing LTx may also be a factor predisposing to significant pulmonary mobility within the pleural space. 2 Furthermore, surgical dissection of pulmonary ligament is another mechanism that increases mobility of lung and therefore increases the risk of torsion. Reperfusion injury and lung consolidation may also play a role in lobar torsion by increasing the lung water and weight.…”