Initial Experiences Of Surgical Techniques And Perioperative Managements Of Lung Retransplantation-A Case Report

BackgroundLung transplantation is on of the most important treatments for end-stage respiratory failure. Although lung retransplantation is the only definitive theraputic option in lung recipients with bronchiolitis obliterans syndrome after lung transplantation, its value remains a considerable source of controversy. Here we share our experience of surgical techniques and perioperative managements of lung retransplantation performed in our center.ObjectiveTo discuss the surgical techniques and perioperative treatment strategies of lung retransplantationMethodWe performed the fisrt case of lung retransplantation to treat a patient of graft dysfunction with bronchiolitis obliterans syndrome in the First Affiliated Hospital of College of Medicine of Zhejiang University on August2011. The surgical approache was contralateral single-lung transplantation, aided by extracorporeal membrane oxygenation. ResultsThe patient was successfully received surgery, and the operative time was143min.The cold ischemia time was140min. The blood loss volume during the operation was2850ml. After operation the patient was treated with control of pulmonary edema, immunosuppressive, anti-infection therapy. The patient was extubated within24hours, and then transferred to general ward in2weeks, and discharge in five weeks. Until now all the perioperative indicators of the patients are satisfied.ConclusionWith strictly controlled indications, properly selected lung recipents,advanced surgical techniques and perioperative managements, lung retransplantation is a safe and effective therapeutic option in lung recipents with bronchiolitis obliterans syndrome after lung transplantation.