Right single lung transplantation using an inverted left don
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A left-to-right inverted LTx is technically feasible using an autologous pericardial conduit for pulmonary venous anastomosis in selected cases.

This technique provides the potential benefit of resolving challenging situations in which surgeons must deal with a patient’s urgency and the logistical limitations of organ allocation.

A left lung graft was offered to a 59-year-old male who had idiopathic pulmonary fibrosis with predominant damage in the right lung. He had been prescribed bed rest with constant oxygen inhalation through an oxymizer pendant and had been on the waiting list for 20 months. Considering the condition of the patient (LAS 34.3) and the scarcity of domestic organ offers, the patient was highly likely to be incapable of tolerating any additional waiting time for another donor organ if he was unable to accept the presently reported offer of a left lung.

Eventually, doctors decided to transplant the left donor lung into the right thorax of the recipient. Because of the anterior-posterior position gap of the hilar structures, the cuff lengths of the pulmonary veins had to be adjusted. The patient did not develop any anastomotic complications after the transplantation.

In conclusion, a left-to-right inverted transplantation is technically feasible in selected cases using an autologous pericardial conduit for pulmonary venous anastomosis. This technique provides the potential benefit of resolving challenging situations in which surgeons must to deal with a patient’s urgency and the logistical limitations of organ allocation.

Source: https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-020-1075-4#Sec3
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