DIFFUSE BRONCHOMALACIA AFTER DOUBLE LUNG TRANSPLANTATION - A CASE-REPORT

A 40 year old woman suffered from respiratory insufficiency (arterial PaO2 = 47 mmHg) because of a chronic beryllium intoxication. On 6th Ju ne 1990, she underwent double lung transplantation with cardio-pulmona ry bypass. Each lung was separately implanted via an extra-pericardial approach, and both bronchi were anastomosed at the hilum. On the seve nth post operative day, a severe bilateral bronchial ischemia was noti ced (black mucosa). Few weeks later, a diffuse bronchomalacia was noti ced in the proximal and distal parts of both bronchial trees. To our k nowledge, such a bronchial post-ischemic complication has never been r eported. The explanation could be several added causes: imperfect pres ervation of the lung during harvesting, post operative pulmonary oedem a, and operative use of an antifibrinolytic agent (aprotinin).