Ouwens J P, van den Berg J W K, van der Bij W, de Boer W J, Koëter G H
Department of Pulmonology, University Hospital Groningen, Groningen, The Netherlands.
J Heart Lung Transplant. 2002 Mar;21(3):395-401. doi: 10.1016/s1053-2498(01)00344-8.
We report a patient who received a single, left lung transplantation for idiopathic pulmonary fibrosis. The effect of the graft on pulmonary improvement was only temporary, because the patient developed obliterative bronchiolitis (OB), resulting in complete destruction of the graft. The patient, however, remains alive 6 years after OB was diagnosed, apparently as a consequence of native lung improvement with triple-immunosuppressive medicine. This case is of interest for several reasons: first, it shows that pulmonary fibrosis may respond to intensive immunosuppressive therapy; second, it demonstrates that ventilation scintigraphy is useful in addition to pulmonary function tests in estimating the actual function of the graft after single lung transplantation; and third, it appears that the gradation of bronchiolitis obliterans syndrome (BOS) after single lung transplantation may overestimate the true function of the transplant.
我们报告了一名因特发性肺纤维化接受单肺移植（左肺）的患者。移植肺对肺部改善的作用只是暂时的，因为该患者发生了闭塞性细支气管炎（OB），导致移植肺完全损毁。然而，该患者在OB诊断后6年仍然存活，显然这是三联免疫抑制药物使自身肺得到改善的结果。该病例之所以令人关注有几个原因：第一，它表明肺纤维化可能对强化免疫抑制治疗有反应；第二，它证明通气闪烁扫描除肺功能测试外，在评估单肺移植后移植肺的实际功能方面是有用的；第三，单肺移植后闭塞性细支气管炎综合征（BOS）的分级似乎可能高估了移植的真实功能。
