Pulmonary Retransplantation For Long-term Complication Of Bronchiolitis Obliterans Syndrome(BOS):A Report Of 5 Cases

Objective:To investigate the outcome of pulmonary retransplantation for recipients with bronchiolitis obliterans syndrome after primary lung transplantation.Methods:Lung retransplantations were performed for 5 recipients with BOS after primary transplantation in Wuxi People's Hospital.The primary diseases of them were diagnosed with end-stage pulmonary diseases,in which there was 1 interstitial pneumonia,1 bronchiectasis,1 pulmonary hypertension,1 BOS following hematopoietic cell transplantation and 1 chronic obstructive pulmonary disease.These recipients with gradual decline in pulmonary function after first lung transplant received lung retransplantations for BOS in 9 months,2 years,3 years,5 years,12years.Two recipients received bilateral sequence lung transplantation and one of which was under extracorporeal membrane oxygenation support.Three recipients received single lung transplantation.Results:The course of operations were smooth.Case 1 died of infection on postoperative day 8 and case 2 died of multiple organ failure resulted from post-resuscitation syndrome on day fourth after operation.The remaining 3 recipients recoved well during the follow-up until now and the pulmonary function was improved significantly.Conclusion:Lung retransplantation is an important therapeutic strategy in treating BOS following initial transplant and the further work is identify patients who benefit most from lung retransplantation for BOS.