Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Successful Bilateral Lung Retransplantation in a Patient with Primary Graft Failure Following a Single Lung Transplantation

일측 폐 이식 후 발생한 이식편 부전으로 양측 폐 재이식을 시행한 1예 보고

  • Hwang Jung-Joo (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Joung Eun-Kyu (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Kim Jae-Ho (Department of Thoracic & Cardiovascular Surgery, Inha University Hospital, Inha University College of Medicine) ;
  • Lee Doo-Yun (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Paik Hyo-Chae (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine)
  • 황정주 (연세대학교 의과대학 영동세브란스병원 흉부외과) ;
  • 정은규 (연세대학교 의과대학 영동세브란스병원 흉부외과) ;
  • 김재호 (인하대학교 의과대학 인하대학병원 흉부외과) ;
  • 이두연 (연세대학교 의과대학 영동세브란스병원 흉부외과) ;
  • 백효채 (연세대학교 의과대학 영동세브란스병원 흉부외과)
  • Published : 2006.06.01
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Abstract

Lung transplantation is the choice of treatment for selected patients with end-stage pulmonary disease. However, retransplantation of the lung due to primary graft failure carries a high risk of morbidity and mortality. This is a case of a 52 year old male with emphysema who continuously needed a ventilator care and a tracheostomy. He underwent a left single lung transplantation but were not able to wean from the ventilator due to primary graft failure, and therefore we decided to do a retransplantation. Bilateral sequential single lung transplantation was performed under the cardiopulmonary bypass. The patient recovered quite well and was discharged and fully active with his work. Retransplantation although it carries a high risk, is a very effective treatment in patients with primary graft failure.

말기 폐질환 환자에서 폐이식은 가장 효과적인 치료이나 원발성 이식부전은 아직도 이식 후 합병증과 사망률 증가의 주 요인이 된다. 폐기종으로 진단된 52세 남자 환자가 지속적 호흡기 치료 및 기관절개 상태에서 좌측 폐이식 수술을 시행 받았다. 본 환자는 이식술 후 발생한 원발성 이식부전으로 호흡기 발관이 불가하여 재이식이 결정되었다. 환자는 인공심폐기 하에 순차적으로 양측 폐이식 수술을 시행 받았으며 현재 퇴원하여 건강하게 일상생활을 하고 있다. 폐이식 수술 후에 발생하는 이식부전이 있으면 가급적 빠른 시일 내에 재이식 수술을 시행하는 것이 예후에 중요하다.

Keywords

References

  1. Meyers BF, de la Morena M, Sweet SC, et al. Primary graft dysfunction and other selected complications of lung transplantation: a single-center experience of 983 patients. J Thorac Cardiovasc Surg 2005;129:1421-9 https://doi.org/10.1016/j.jtcvs.2005.01.022
  2. Christie JD, Kotloff RM, Kotloff RM, et al. Clinical risk factors for primary graft failure following lung transplantation. Chest 2003;124:1232-41 https://doi.org/10.1378/chest.124.4.1232
  3. Venuta F, Rendina EA, Bufi M, et al. Preimplantation retrograde pneumoplegia in clinical lung transplantation. J Thorac Cardiovasc Surg 1999;118:107-14 https://doi.org/10.1016/S0022-5223(99)70149-2
  4. Sarsam MA, Yonan NA, Beton D, McMaster D, Deiraniya AK. Early pulmonary vein thrombosis after single lung transplantation. J Heart Lung Transplant 1993;12:17-9
  5. Parekh K, Patterson GA. Technical considerations in adult lung transplantation. Semin Thorac Cardiovasc Surg 2004; 16:322-32 https://doi.org/10.1053/j.semtcvs.2004.09.013
  6. Taylor DO, Edwards LB, Hertz MI, et al. Registry of the International Society for Hurt and Lung Transplantation: twenty-second official adult heart transplant report-2005. J Heart Lung Transplant 2005;24:945-55 https://doi.org/10.1016/j.healun.2005.05.018
  7. Kotloff RM. Lung retransplantation-all for one or one for all. Chest 2003;123:1781-2 https://doi.org/10.1378/chest.123.6.1781
  8. Novie RJ, Still L. Pulmonary retransplantation. Semin Thorac Cardiovasc Surg 1998;10:227-36 https://doi.org/10.1016/S1043-0679(98)70041-3