SINGLE-LUNG TRANSPLANTATION IN A PATIENT WITH CYSTIC-FIBROSIS AND ARTASYMMETRIC THORAX

We report metachronous single-lung transplantation for cystic fibrosis after contralateral pneumonectomy. Kyphoscoliosis and mediastinal shi ft required careful donor-lung sizing with computed tomography and was not dependent on typical parameters. Severe reperfusion injury was tr eated with nitric oxide, C1-esterase inhibitor, and continuous venoven ous hemodialysis. The patient was extubated on the fifth postoperative day and is alive and well. We conclude that single-lung transplantati on after contralateral pneumonectomy for patients with cystic fibrosis and an asymmetric chest and evident lung volume mismatch may be an ac ceptable functional therapeutic option. (C) 1997 by The Society of Tho racic Surgeons.