Lung Transplantation for Lymphangioleiomyomatosis

Boehler, Annette; Speich, Rudolf; Russi, Erich W.; Weder, Walter

doi:10.1056/nejm199610243351704

Cited by 205 publications

(112 citation statements)

References 30 publications

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“…1,2) In these cases, longterm drainage is necessary due to the large amount of pleural effusion and it can be an obstacle to physical and pulmonary rehabilitation after transplant. Dietary manipulation, such as a low-fat medium-chain triglyceride diet and complete cessation of oral intake, can be an initial treatment for postoperative chylothorax.…”

Section: Discussionmentioning

confidence: 99%

“…1,3) In considering thoracic duct ligation, we performed thoracic duct scintigraphy to locate the injury site of the thoracic duct in the present case. However, our results showed diffuse accumulation of radiotracer in the left thoracic cavity and we did not identify its leakage site from the thoracic duct.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that chylothorax occurred in 6% to 9 % of patients who received transplants for LAM. 1,2) It is often difficult to treat or control chylous effusion in LAM patients because of the typically large amount of effusion. Several treatments have been reported for chylothorax in LAM patients.…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment options, such as pleuroperitoneal shunt and thoracic duct ligation, are also performed on patients with a large amount of pleural effusion. 1,3) We report the case of a mid-thirties female who developed severe chylothorax after bilateral lung transplantation for LAM and was treated successfully by injection of fibrin glue into the thoracic cavity.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Successful Therapy by Intrapleural Injection of Fibrin Glue for Chylothorax after Lung Transplantation for Lymphangioleiomyomatosis

Oishi

Hoshikawa

Sado

et al. 2017

ATCS

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A 37-year-old woman underwent bilateral lung transplantation for lymphangioleiomyomatosis. Dense pleural adhesions due to past pleurodesis for chylothorax were observed and dissected in both thoracic cavities. The patient developed chylothorax after transplant. Chylothorax in the right thoracic cavity was successfully treated by conventional pleurodesis; however, pleural effusion from the left thoracic cavity was not reduced. According to fluoroscopic images obtained by injecting a contrast medium through the chest tube, the remaining pleural space in the left thoracic cavity was small and localized in the lower region adjacent to the mediastinum. We opted to fill this space with fibrin glue; we injected fibrinogen and thrombin solution into the space through the chest tube. We performed fibrin glue treatment three times and pleural effusion was dramatically decreased. We removed the chest tube on day 107 post-transplant. No recurrent chylothorax has been recorded for 10 years after lung transplantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Case of Successful Therapy by Intrapleural Injection of Fibrin Glue for Chylothorax after Lung Transplantation for Lymphangioleiomyomatosis

Oishi

Hoshikawa

Sado

et al. 2017

ATCS

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“…In our opinion, the hormonal manipulation has been attempted with questionable success although those therapeutic modalities had beneficial effects on chylothorax or chylous ascites in some cases. The treatment for pulmonary LAMto date has not been very effective and further studies including lung transplantation (18,19) are necessary.…”

Section: Case Reportmentioning

confidence: 99%

Pulmonary Lymphangiomyomatosis (LAM) Developing Chylothorax.

et al. 2000

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Wedescribe a case of pulmonary lymphangiomyomatosis (LAM)with chylothorax that developed in a 46-year-old Japanese woman.This patient exhibited clinical symptoms of dyspnea and chest X-ray showed right pleural effusion. Thoracocentesis demonstrated chylous effusion. Chest computed tomography (CT) scan revealed multiple cystic lesions. Subsequent thoracoscopy revealed the chylorrhea from swelled vessels on the diaphragm. The clinical diagnosis, based on histological examinations with biopsy specimens obtained by thoracoscopy, was pulmonary LAM.Although the hormonetherapy was not effective, chylous effusion was improved by the pleurodesis. Pulmonary LAM developing chylothorax is rare in Japan. (Internal Medicine 39: 738-741, 2000)

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Meningiomas in Lymphangioleiomyomatosis

Moss¹

2001

JAMA

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Women with LAM appear to have a high prevalence of meningiomas. We recommend that patients with LAM be screened for meningiomas regardless of diagnosis of TSC. In view of the lack of a documented effect of progesterone on progression of lung disease in LAM and the reported mitogenic response of meningiomas to progesterone, we recommend that the drug not be given to LAM patients with an MRI result consistent with diagnosis of meningioma.

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Lung Transplantation for Lymphangioleiomyomatosis

Abstract: Although disease-related complications are frequent, lung transplantation can be a valuable therapy for patients with end-stage lymphangioleiomyomatosis.

Cited by 205 publications

References 30 publications

A Case of Successful Therapy by Intrapleural Injection of Fibrin Glue for Chylothorax after Lung Transplantation for Lymphangioleiomyomatosis

A Case of Successful Therapy by Intrapleural Injection of Fibrin Glue for Chylothorax after Lung Transplantation for Lymphangioleiomyomatosis

Pulmonary Lymphangiomyomatosis (LAM) Developing Chylothorax.

Meningiomas in Lymphangioleiomyomatosis

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