Single-Lung Transplantation in a Patient With Cystic Fibrosis and an Asymmetric Thorax

Single-lung transplantation in patients with previous contralateral pneumonectomy: technical aspects and results

“…SLTX in patients who previously underwent a PN is a rare opportunity; data restricted to the case reports [1][2][3] are lacking in the literature. This short series permits disclosure of various SLTX technical aspects induced by the previous PN.…”

“…This therapeutic sequence may be observed in two different situations: PN indicated to postpone LTX for asymmetrical disease resulting in a two-stage procedure or PN carried out before, independently of the LTX programme. The first reported cases in 1997 [1] confirmed the feasibility but disclosed technical difficulties mainly related to mediastinal shift. Since then, only two cases were reported [2,3].…”

“…As in cases of asymmetrical thorax [1,11], the morphological study also allows evaluation of the donor's ideal size by calculating it from the oversized single lung induced by the bigger volume of the recipient's pleural cavity. To do that, extrapolation of an optimal donor's mensurations should be done according to the size of the recipient's single lung.…”

Intracerebral Abscess: A Complication of Severe Cystic Fibrosis Lung Disease

“…Our patient, who did not have respiratory failure, raises the question of the value of pneumonectomy in patients with a chronically infected/colonized nonfunctioning lung with a 'preserved' forced expiratory volume in 1 s. Pneumonectomy in CF patients has multiple considerationschief among them are complications (eg, bronchopleural fistula, inoculation or colonization of the resected hemithorax, and ventilator dependence) and potential adverse effects on lung transplantation. Current literature suggests that pneumonectomy is not a contraindication to future lung transplant (14)(15)(16)(17). The issue of pneumonectomy was raised at several points before his final hospitalization, but he was dismissed as being too risky (ie, high incidence of bronchopleural fistula) (5).…”

“…A lung transplant specialist indicated that an uncomplicated postoperative course in the present patient would not preclude a future unilateral or single lung transplant of the left lung. The literature around this issue suggests that most patients do well and have improved quality of life, and reduced numbers of infections or hospitalizations (13,14,16,17).…”