Couetil J P, Argyriadis P G, Tolan M J, Achkar A, Carpentier A F
Department of Cardiovascular Surgery, European Hospital George Pompidou, Paris, France.
Ann Thorac Surg. 2001 Sep;72(3):933-5. doi: 10.1016/s0003-4975(01)02394-3.
Since the inception of lung transplantation in 1982, it has been standard practice to implant donor lungs on the ipsilateral side in the recipient. The development of the techniques of lobar and bilateral lobar transplantation has shown that lung morphology may adapt to the shape of the thorax. Thus, variations in implantation have become possible. We describe a case of a 30-year-old man with severe bronchiectasis due to ciliary dyskinesis which required a left lower lobectomy at the age of 11 years and a left completion pneumonectomy 10 years later. His disease progressed and he was listed for a right lung transplantation. At the time of transplantation, the donor right lung was noted to be edematous and unfit for transplantation. This required grafting the donor left lung in the right thorax of the recipient. Follow-up at 7 years shows good exercise capacity and excellent functional tests without evidence of rejection.
自1982年肺移植开展以来，将供体肺植入受体同侧一直是标准做法。肺叶及双侧肺叶移植技术的发展表明，肺的形态可能会适应胸廓的形状。因此，植入方式的变化成为可能。我们描述了一例30岁男性患者，因纤毛运动障碍导致严重支气管扩张，11岁时接受了左下肺叶切除术，10年后接受了左全肺切除术。他的病情进展，被列入右肺移植名单。在移植时，发现供体右肺水肿，不适合移植。这就需要将供体左肺植入受体的右胸腔。7年的随访显示患者运动能力良好，功能测试结果优异，无排斥反应迹象。
