Lung transplantation for Kartagener syndrome: technical aspects and morphological adaptation of the transplanted lungs

Abstract

While technical considerations in lung transplantation for Kartagener syndrome have been discussed, little information is available about the postoperative morphological changes of the grafted lungs. Herein, we discuss both the technical aspects and postoperative morphological adaptation of the grafted lungs in a case of Kartagener syndrome. A 46-year-old male patient with Kartagener syndrome underwent bilateral cadaveric lung transplantation. The right arterial anastomosis for transplantation of the size-matched grafts required technical elaboration. After the transplantation, we found a free space in the cardiac notch of the left lung and partial collapse of the lower lobe of the right lung due to dextrocardia. Follow-up computed tomography performed on day 42 after the transplantation demonstrated resolution of the atelectasis and morphological adaptation of the grafts into the recipient's chest cavity with dextrocardia. Considering such early morphological adaptation of size-matched grafts, lobar reduction could be avoided in lung transplantation for Kartagener syndrome.

Pulmonary artery anastomosis during lung transplantation: a novel technique

“…PAA is a crucial step in lung transplantation; the quality of the anastomosis has a significant impact on the circulation and function of the transplanted lung ( 1 - 3 ). Conventional PAA techniques, such as interrupted, simple continuous, and stapler-assisted sutures, can be associated with varying degrees of bleeding, torsion, deformity, and other complications ( 4 - 7 ).…”

Bridge to second double lung transplant with an extracorporeal carbon dioxide removal system in sites inversus patient

“…Lung transplantation in patients with Kartagener's syndrome and situs inversus challenges include: dextrocardia with discrepancies between donor and recipient vessels and airways [4][5][6][7] . In addition, the chest cavity mismatch between the donor right lung between and the recipient's dextrocardia can result in right lower lobe atelectasis and kinks of the pulmonary artery.…”

Bridge to second double lung transplant with an extracorporeal carbon dioxide removal system in situs inversus patient

“…Lung transplantation in patients with Kartagener's syndrome and situs inversus challenges include dextrocardia with discrepancies between donor and recipient vessels and airways. [5][6][7][8] In addition, the chest cavity mismatch between the donor right lung between and the recipient's dextrocardia can result in right lower lobe atelectasis and kinks of the pulmonary artery. In the present report, we did not experience any anastomotic or postoperative challenges.…”