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Successful lung transplantation after prone positioning in an ineligible donor: a case report

Atelectasis is a reversible factor in hypoxemia among brain-dead donors. In ineligible donors, prone positioning reverses atelectasis and improves oxygenation. We present a successful lung transplantation after salvaging a previously unviable lung. A 37-year-old woman presented with acute pontine he...

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Autores principales: Son, Eunjeong, Jang, Jinook, Cho, Woo Hyun, Kim, Dohyung, Yeo, Hye Ju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Singapore 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8218964/
https://www.ncbi.nlm.nih.gov/pubmed/34159516
http://dx.doi.org/10.1007/s11748-021-01676-4
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author Son, Eunjeong
Jang, Jinook
Cho, Woo Hyun
Kim, Dohyung
Yeo, Hye Ju
author_facet Son, Eunjeong
Jang, Jinook
Cho, Woo Hyun
Kim, Dohyung
Yeo, Hye Ju
author_sort Son, Eunjeong
collection PubMed
description Atelectasis is a reversible factor in hypoxemia among brain-dead donors. In ineligible donors, prone positioning reverses atelectasis and improves oxygenation. We present a successful lung transplantation after salvaging a previously unviable lung. A 37-year-old woman presented with acute pontine hemorrhage that progressed to brain death. The initial partial pressure of oxygen (PaO(2))/fraction of inspired oxygen (FiO(2)) ratio of the donor’s lung was 342 mmHg. The PaO(2)/FiO(2) ratio dropped to 49 mmHg due to atelectasis. There was no improvement despite recruitment maneuvers, bronchoscopy, and chest percussion. After placing the donor in the prone position for four hours, electrical impedance tomography showed improved atelectasis. The donor did not experience hemodynamic instability. The lung was transplanted into a patient with Kartagener’s syndrome with situs inversus. The surgical procedure was uneventful. He was successfully weaned from the mechanical ventilator on the second-day post-transplantation and was discharged from the hospital after 4 weeks.
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spelling pubmed-82189642021-06-23 Successful lung transplantation after prone positioning in an ineligible donor: a case report Son, Eunjeong Jang, Jinook Cho, Woo Hyun Kim, Dohyung Yeo, Hye Ju Gen Thorac Cardiovasc Surg Case Report Atelectasis is a reversible factor in hypoxemia among brain-dead donors. In ineligible donors, prone positioning reverses atelectasis and improves oxygenation. We present a successful lung transplantation after salvaging a previously unviable lung. A 37-year-old woman presented with acute pontine hemorrhage that progressed to brain death. The initial partial pressure of oxygen (PaO(2))/fraction of inspired oxygen (FiO(2)) ratio of the donor’s lung was 342 mmHg. The PaO(2)/FiO(2) ratio dropped to 49 mmHg due to atelectasis. There was no improvement despite recruitment maneuvers, bronchoscopy, and chest percussion. After placing the donor in the prone position for four hours, electrical impedance tomography showed improved atelectasis. The donor did not experience hemodynamic instability. The lung was transplanted into a patient with Kartagener’s syndrome with situs inversus. The surgical procedure was uneventful. He was successfully weaned from the mechanical ventilator on the second-day post-transplantation and was discharged from the hospital after 4 weeks. Springer Singapore 2021-06-22 2021 /pmc/articles/PMC8218964/ /pubmed/34159516 http://dx.doi.org/10.1007/s11748-021-01676-4 Text en © The Japanese Association for Thoracic Surgery 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Case Report
Son, Eunjeong
Jang, Jinook
Cho, Woo Hyun
Kim, Dohyung
Yeo, Hye Ju
Successful lung transplantation after prone positioning in an ineligible donor: a case report
title Successful lung transplantation after prone positioning in an ineligible donor: a case report
title_full Successful lung transplantation after prone positioning in an ineligible donor: a case report
title_fullStr Successful lung transplantation after prone positioning in an ineligible donor: a case report
title_full_unstemmed Successful lung transplantation after prone positioning in an ineligible donor: a case report
title_short Successful lung transplantation after prone positioning in an ineligible donor: a case report
title_sort successful lung transplantation after prone positioning in an ineligible donor: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8218964/
https://www.ncbi.nlm.nih.gov/pubmed/34159516
http://dx.doi.org/10.1007/s11748-021-01676-4
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