Outcome of lung transplantation in cystic fibrosis patients with severe asymmetric chest cavities

Double lung transplantation in patients with lung atelectasis and complete mediastinal shift

“…The included patients ranging from a simple mediastinal shift causing a minor difference in the two cavities to patients with severe scoliosis seen on CT scan. While the study group remained small, they reported outcomes to be worse in patients with asymmetric chest cavities 6 …”

“…While the study group remained small, they reported outcomes to be worse in patients with asymmetric chest cavities. 6 In rare, advanced cases, patients may present with a completely collapsed ipsilateral lung with concurrent retracted asymmetric hemithorax. This often poses significant surgical challenges in lung transplantation, and several surgical techniques have been presented in several small case reports with good results.…”

Commentary: Paving the way with visualization of the invisible craftsmanship

“…Another main concern is the confusion regarding the surgical modality to be applied from among the 4 types described by Sinn and colleagues. 2 …”

“…In the decision regarding surgical options, size matching with the assessment of the correct dimensions is essential. 3 Sinn and colleagues 2 tried to perform 3-dimensional computed tomography (3D-CT) volumetry of recipient CT scans retrospectively to better quantify the volume of both chest cavities; however, it was unfortunate that only less than half of CT scans were electronically available. Because 3D-CT volumetry might be a useful tool for living-donor lobar lung transplantation, 3 , 4 for patients with asymmetric chest cavities, preoperative evaluation using 3D-CT volumetry is recommended in addition to the consideration of the shape and configuration of the chest by an experienced surgeon.…”

“…In this issue of the Journal , Sinn and colleagues 2 provided persuasive data on short- and long-term outcomes in 13 patients with CF with severe asymmetric chest cavities undergoing lung transplantation. Several reports of successful lung transplantations for patients with CF and asymmetric chest cavities were sporadically performed, but none of them provided long-term follow-up and survival data.…”