Lung Transplantation in a Patient with Fibrosing Alveolitis

Abstract

SummaryThe transplantation of the right lung into a man aged 40 who was suffering from cryptogenic fibrosing alveolitis is described. Before transplantation he had been dependent on oxygen, even at rest, for 24 hours a day for almost two years. The donor was a boy of 16 years who had had a fatal cerebral haemorrhage. The transplanted lung functioned perfectly from the time of operation until the patient's sudden death two months later from an overwhelming haemoptysis apparently from a small peribronchial abscess rupturing into the pulmonary artery. By the third postoperative week the patient had been able to walk unaided and without distress outdoors. The problem of differentiating infection from incipient rejection is discussed. We conclude that clinically successful lung transplantation can be achieved, but only if the problems of lung function, infection, and immunosuppression can all be overcome.

Distinction between Infection and Rejection in Lung Transplantation

“…Although some of this information has been reported (Hugh-Jones et al, 1971) the additional considerations given here have important implications, not only for lung transplantation but for transplantation generally.…”

“…Details of clinical progress have already been presented (Hugh-Jones et al, 1971). The relevant features are compared with the immunological changes that occurred (Fig.…”

Pathological findings after right lung transplantation in a patient with fibrosing alveolitis

“…Hugh-Jones, Macarthur, Cullum, Mason, Crosbie, Hutchison, Winterton, Smith, Mason, and Smith (1971) reported the transplantation ofasingle lung to a patient with fibrosing alveolitis which produced dramatic improvement in lung function during the two months that the patient survived. Those pathological findings relevant in establishing the mode of death, the nature and severity of the disease in the resected and residual lungs, and the changes that developed in the donor lung are reported here.…”

“…Those pathological findings relevant in establishing the mode of death, the nature and severity of the disease in the resected and residual lungs, and the changes that developed in the donor lung are reported here. Case Report Details of the patient's clinical record have previously been reported (Hugh-Jones et al, 1971). He had finger clubbing from the age of 15 years but did not develop breathlessness until he was 30 when it became progressively worse.…”