Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Gen Thorac Cardiovasc Surg. 2021 Mar;69(3):588-592. doi: 10.1007/s11748-020-01509-w. Epub 2020 Oct 7.
While technical considerations in lung transplantation for Kartagener syndrome have been discussed, little information is available about the postoperative morphological changes of the grafted lungs. Herein, we discuss both the technical aspects and postoperative morphological adaptation of the grafted lungs in a case of Kartagener syndrome. A 46-year-old male patient with Kartagener syndrome underwent bilateral cadaveric lung transplantation. The right arterial anastomosis for transplantation of the size-matched grafts required technical elaboration. After the transplantation, we found a free space in the cardiac notch of the left lung and partial collapse of the lower lobe of the right lung due to dextrocardia. Follow-up computed tomography performed on day 42 after the transplantation demonstrated resolution of the atelectasis and morphological adaptation of the grafts into the recipient's chest cavity with dextrocardia. Considering such early morphological adaptation of size-matched grafts, lobar reduction could be avoided in lung transplantation for Kartagener syndrome.
虽然已经讨论了卡塔格内综合征肺移植中的技术考虑因素,但有关移植物肺部术后形态变化的信息却很少。在此,我们讨论了卡塔格内综合征患者的肺移植的技术方面和术后形态适应。一位 46 岁的男性卡塔格内综合征患者接受了双侧尸体肺移植。大小匹配移植物的右动脉吻合需要技术阐述。移植后,我们发现左肺心切迹有空腔,由于右位心,右下肺部分塌陷。移植后 42 天的随访 CT 显示,肺不张已解决,并且移植物与右位心受者胸腔的形态适应。考虑到大小匹配移植物的这种早期形态适应,可以避免在卡塔格内综合征的肺移植中进行肺叶切除术。