Contvalateral Single Lung Re-transplantation in the Patient with Lymphangioleiomyomatosis due to Graft Failure

폐림프관 평활근종증 환자에서 이식편 기능부전에 의한 반대쪽 단측폐 재이식수술

  • Joung Eun-Kyu (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Hwang Jung-Joo (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Kim Jae-Ho (Department of Thoracic & Cardiovascular Surgery, Inha University Hospital, Inha University School of Medicine) ;
  • Youn Young-Nam (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Lee Doo-Yun (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Paik Hyo-Chae (Department of Thoracic & Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine)
  • 정은규 (연세대학교 의과대학 영동세브란스병원 흉부외과) ;
  • 황정주 (연세대학교 의과대학 영동세브란스병원 흉부외과) ;
  • 김재호 (인하대학교 의과대학 인하대학교병원 흉부외과) ;
  • 윤영남 (연세대학교 의과대학 영동세브란스병원 흉부외과) ;
  • 이두연 (연세대학교 의과대학 영동세브란스병원 흉부외과) ;
  • 백효채 (연세대학교 의과대학 영동세브란스병원 흉부외과)
  • Published : 2006.04.01

Abstract

Lymphangioleiomyomatosis (LAM) is a rare disease in women of childbearing ages that eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic modality in end-stage LAM. While single-lung transplantation is the preferred operation, the graft failure or recurrence of LAM was reported. We performed a single lung transplantation on a 36-year-old woman suffering from respiratory failure due to lymphangioleiomyomatosis. After a 1-year follow up, the patient was readmitted because of graft failure with collapsed transplanted lung. The lung volume reduction surgery (LVRS), tracheostomy and ventilator care were performed. However, neither the medical nor surgical treatment had any effect. Subsequently, we performed a contralateral single lung re-transplantation and had a good postoperative results.

호흡부전을 동반한 말기 폐림프관 평활근종증은 가임기 여성에서 발병하는 매우 드문 질환으로서 폐이식이 유일한 치료법으로 알려져 있다. 이런 환자에서 폐이식을 시행하는 경우 단측 폐이식이 추천되고 있으나 이식한 폐의 기능부전이나 이식하지 않은 폐에서 원발질환의 악화가 문제점으로 제시되고 있다. 본원에서는 폐림프관 평활근종증을 앓고 있던 말기 호흡부전의 36세 여자 환자에게 우측 단일 폐이식술을 시행한 이후 이식폐의 폐허탈로 인한 기능부전으로 인하여 내과적 또는 외과적 치료에도 불구하고 호전이 없어 반대쪽의 단측폐 재이식수술을 시행한 후 좋은 결과를 얻었기에 이를 보고하는 바이다.

Keywords

References

  1. Burrell LST, Ross JM. A case of chylous effusion due to leiomyosarcoma. Br J Tuberc 1937;31:38-9 https://doi.org/10.1016/S0366-0850(37)80087-3
  2. Sung SW, Kim JH, Kim YT, et al. Bilateral sequential lung transplantation for a case with respiratory failure due to lymphangioleiomyomatosis. Korean J Thorac Cardiovasc Surg 2000;33:88-95
  3. Yang HC, Kim K, Choi YS, Kim J, Shim YM. Single lung transplantation in the patient with end-stage lymphangioleiomyomatosis. Korean J Thorac Cardiovasc Surg 2004;37: 1015-8
  4. Pechet TT, Meyers BF, Guthrie TJ, et al. Lung transplantation for lymphangioleiomyomatosis. J Heart Lung Transplant 2004;23:301-8 https://doi.org/10.1016/S1053-2498(03)00195-5
  5. Cho HM, Paik HC, Kim DH, Kang DY, Lee DY. The single lung transplantation for end-stage emphysema by functional criteria. Korean J Thorac Cardiovasc Surg 2003;36:101-4
  6. Weill D, Torres F, Hodges TN, et al. Acute native lung hyperinflation is not associated with poor outcomes after single lung transplant for emphysema. J Heart Lung Transplant 1999;18:1080-7 https://doi.org/10.1016/S1053-2498(99)00079-0
  7. Novick RJ, Stitt LW, Al-Kattan K, et al. Pulmonary retransplantation: predictors of graft function and survival in 230 patients. Pulmonary retransplant registry. Ann Thorac Surg 1998;65:227-34 https://doi.org/10.1016/S0003-4975(97)01191-0
  8. Wekerle T, Klepetko W, Wisser W, et al. Lung retransplantation: institutional report on a series of twenty patients. J Heart Lung Transplant 1996;15:182-9