eMedicine Specialties > Transplantation > Surgery
Lung Transplantation: Multimedia
Updated: May 13, 2009
Multimedia
 | Media file 1: This chest radiograph performed 24 hours following right unilateral lung transplantation is within normal limits. |
 | Media file 2: Seventy-two hours following lung transplantation, this patient developed dyspnea and hypoxemia. The bronchoscopy and bronchoalveolar lavage revealed no evidence of bacterial infection. The likely cause of this deterioration is reperfusion/reimplantation response. |
 | Media file 3: A 19-year-old woman had living donor transplantation. She developed pulmonary artery stenosis several months later. This was treated with a pulmonary artery stent. Courtesy of A. Szabo, RN. |
 | Media file 4: This patient developed anterior mediastinal abscess 1 year following bilateral sequential lung transplantation. Courtesy of A. Szabo, RN. |
 | Media file 5: Lateral chest radiograph on a patient who developed anterior mediastinal abscess 1 year following bilateral sequential lung transplantation (see Image 4). Courtesy of A. Szabo, RN. |
 | Media file 6: The CT scan of the chest of a patient with confirmed anterior mediastinal abscess 1 year following bilateral sequential lung transplantation. Courtesy of A. Szabo, RN. |
 | Media file 7: A 34-year-old man developed branchio-otorenal (BOR) syndrome 3 years following sequential bilateral lung transplant (BLT). The chest radiograph shows characteristic findings of hyperinflation and hyperlucent lung fields. Courtesy of A. Szabo, RN. |
 | Media file 8: Lateral radiograph of a 34-year-old man who developed branchio-otorenal (BOR) syndrome 3 years following sequential bilateral lung transplant (BLT). The chest radiograph shows characteristic findings of hyperinflation and hyperlucent lung fields. Courtesy of A. Szabo, RN. |
 | Media file 9: The high-resolution CT scan showing findings of branchio-otorenal (BOR) syndrome following bilateral lung transplantation (BLT). |
 | Media file 10: Bronchopleural fistula following right pneumonectomy and left single-lung transplantation (SLT). |
 | Media file 11: Severe acute rejection within 10 days of lung transplantation (lower magnification). The typical histological findings are perivascular lymphocytic infiltrates. Courtesy of Zhaolin Xu, MD. |
 | Media file 12: Severe acute rejection within 10 days of lung transplantation (high power). Courtesy of Zhaolin Xu, MD. |
 | Media file 13: The transbronchial biopsy shows perivascular aggregates of lymphocytes in the low-power field, which is indicating acute rejection in this patient 60 days after the lung transplant. This is grade II rejection. Courtesy of Zhaolin Xu, MD. |
 | Media file 14: The transbronchial biopsy shows perivascular aggregates of lymphocytes in the high-power field, which indicates acute rejection in this patient 60 days after the lung transplant. This is grade II rejection. Courtesy of Zhaolin Xu, MD. |
 | Media file 15: Bronchial anastomosis. Posterior wall closure is performed with a continuous suture. |
 | Media file 16: Right atrial anastomosis. Continuous anastomosis with the common pulmonary vein joined to the atrium. |
 | Media file 17: Completed atrial anastomosis. |
 | Media file 18: Donor lung showing hilar surface. |
 | Media file 19: The clamps are exposing the donor vein. |
 | Media file 20: Donor bronchus, artery to the right and vein to the left. |
 | Media file 21: Right donor bronchus. |
 | Media file 22: A close-up shot of the donor vein. |
 | Media file 23: Bilateral lung transplantation to treat cystic fibrosis in a 23-year-old woman. Anteroposterior (AP) chest radiograph shows mild edema in the right perihilar region soon after surgery; this finding is consistent with an implantation response. |
 | Media file 24: Anteroposterior (AP) chest radiograph in same patient as in previous Image in Multimedia obtained the following day shows increased edema. |
 | Media file 25: Bilateral lung transplants in 23-year-old woman who developed infection at the bronchial anastomoses. CT scan shows right bronchial stenosis (arrow). |
 | Media file 26: CT image in same patient as in previous Image in Multimedia shows left bronchial stenosis (arrow). |
 | Media file 27: Posteroanterior (PA) chest radiograph in a 23-year-old woman who underwent bilateral lung transplantation because of cystic fibrosis. Image shows left upper-lobe collapse. Bilateral bronchial stents are in place. |
 | Media file 28: Lateral radiograph corresponding to previous Image in Multimedia shows left upper-lobe collapse. Arrow points to a bronchial stent. Bronchoscopy showed that scar tissue obliterated the orifice to the left upper-lobe bronchus. |
 | Media file 29: CT image in a 61-year-old-woman with a single-lung transplant for emphysema with Aspergillus infection. Image shows an ill-defined nodule in the right upper lobe with a surrounding halo of ground-glass opacity (arrow), a finding virtually diagnostic of Aspergillus infection in the correct clinical setting. |
 | Media file 30: Aspergillus infection 61-year-old man with a left lung transplant because of idiopathic pulmonary fibrosis. Frontal chest radiograph shows a normal left (transplant) lung and lower-lobe consolidation in the right (native) lung. |
 | Media file 31: CT of patient in previous Image in Multimedia shows patchy areas of consolidation in the right lower lobe and a clear left lung. Biopsy showed Aspergillus infection. |
 | Media file 32: Cytomegaloviral (CMV) infection in a 52-year-old man with a right lung transplant because of emphysema. Frontal chest radiograph shows right lower-lobe and left mid-lung consolidation and a small right pleural effusion. Note that the less-compliant transplant lung pulls the mediastinum to the right. |
 | Media file 33: CT of the patient in previous Image in Multimedia with cytomegaloviral (CMV) pneumonia shows patchy consolidation, greater on the right (transplant lung) than on the left, and a right pleural effusion. |
 | Media file 34: Chest radiograph in bilateral lung transplant recipient showing bilateral pneumothoraces (arrows). |
 | Media file 35: CT of patient in previous Image in Multimedia shows pneumothorax in common pleural space (arrow). |
 | Media file 36: Lung carcinoma in lung transplant recipient. PA chest radiograph shows a spiculated nodule in the lower lobe of the native right lung. |
 | Media file 37: Primary lung carcinoma in lung transplant recipient. CT scan of patient with previous radiograph shows spiculated nodule in the lower lobe of the emphysematous native right lung (arrow). |
 | Media file 38: Post-transplant lymphoproliferative disorder in double lung transplant recipient. Contrast-enhanced CT scan shows low attenuation mass (arrow) in the anterior mediastinum. |
More on Lung Transplantation |
| Overview: Lung Transplantation |
| Workup: Lung Transplantation |
| Treatment: Lung Transplantation |
| Follow-up: Lung Transplantation |
 Multimedia: Lung Transplantation |
| References |
| « Previous Page |
References
Christie JD, Edwards LB, Aurora P, Dobbels F, Kirk R, Rahmel AO, et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-fifth Official Adult Lung and Heart/Lung Transplantation Report-2008. J Heart Lung Transplant. 2008;27:957-969. [Medline].
Demikhov VP. Experimental Transplantation of Vital Organs. New York: Consultants Bureau; 1962.
Hardy JD, Eraslan S, Dalton ML Jr. Autotransplantation and homotransplantation of the lung: further studies. J Thorac Cardiovasc Surg. Nov 1963;46:606-15. [Medline].
Toronto Lung Transplant Group. Unilateral lung transplantation for pulmonary fibrosis. N Engl J Med. May 1 1986;314(18):1140-5. [Medline].
Patterson GA, Cooper JD, Goldman B, et al. Technique of successful clinical double-lung transplantation. Ann Thorac Surg. Jun 1988;45(6):626-33. [Medline].
Cooley DA, Bloodwell RD, Hallman GL. Organ transplantation for advanced cardiopulmonary disease. Ann Thorac Surg. 1969;8:300-302.
Reitz BA, Wallwork JL, Hunt SA. Heart-lung transplantation: successful therapy for patients with pulmonary vascular disease. N Engl J Med. Mar 11 1982;306(10):557-64. [Medline].
ASTP/ATS/ERS/ISHLT. International guidelines for the selection of lung transplant candidates. American Society for Transplant Physicians/American Thoracic Society/European Respiratory Society/International Society for Heart and Lung Transplantation. Am J Respir Crit Care Med. Jul 1998;158(1):335-9. [Medline].
Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. NEJM. 2004;350:1005-1012. [Medline].
Mogulkoc N, Brutsche MH, Bishop PW, Greaves SM, Horrocks AW, Egan JJ; Greater Manchester Pulmonary Fibrosis Consortium. Pulmonary function in idiopathic pulmonary fibrosis and referral for lung transplantation. Am J Respir Crit Care Med. 2001;164:103-108. [Medline].
Barst RJ, Rubin LJ, Long WA. A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. The Primary Pulmonary Hypertension Study Group. N Engl J Med. Feb 1 1996;334(5):296-302. [Medline].
Olschewski H, Walmrath D, Schermuly R. Aerosolized prostacyclin and iloprost in severe pulmonary hypertension. Ann Intern Med. May 1 1996;124(9):820-4. [Medline].
Liou TG, Adler FR, Fitzsimmons SC. Predictive 5-year survivorship model of cystic fibrosis. Am J Epidemiol. Feb 15 2001;153(4):345-52. [Medline].
Orens JB, Estenne M, Arcasoy S, Conte JV, Corris P, Egan JJ, et al. International Guidelines for the Selection of Lung Transplant Candidates: 2006 Update-A Consensus Report From the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2006;25:745-755. [Medline].
Meyers BF, Lynch JP, Battafarano RJ. Lung transplantation is warranted for stable, ventilator-dependent recipients. Ann Thorac Surg. Nov 2000;70(5):1675-8. [Medline].
Low DE, Trulock EP, Kaiser LR. Morbidity, mortality, and early results of single versus bilateral lung transplantation for emphysema. J Thorac Cardiovasc Surg. Jun 1992;103(6):1119-26. [Medline].
Hachem RR, Edwards LB, Yusen RD, Chakinala MM, Alexander Patterson G, Trulock EP. The impact of induction on survival after lung transplantation: an analysis of the International Society for Heart and Lung Transplantation Registry. Clin Transplant. 2008;22:603-608. [Medline].
Kobashigawa JA, Miller LW, Russell SD, Ewald GA, Zucker MJ, Goldberg LR, et al. Tacrolimus with mycophenolate mofetil (MMF) or sirolimus vs. cyclosporine with MMF in cardiac transplant patients: 1-year report. Am J Transplant. 2006;6:1243-1245. [Medline].
McNeil K, Glanville AR, Wahlers T, Knoop C, Speich R, Mamelok RD, et al. Comparison of mycophenolate mofetil and azathioprine for prevention of bronchiolitis obliterans syndrome in de novo lung transplant recipients. Transplantation. 2006;15:998-1003. [Medline].
Groetzner J, Wittwer T, Kaczmarek I, Ueberfuhr P, Strauch J, Nagib R, et al. Conversion to sirolimus and mycophenolate can attenuate the progression of bronchiolitis obliterans syndrome and improves renal function after lung transplantation. Transplantation. 2006;81:355-360. [Medline].
Snell GI, de Hoyos A, Krajden M. Pseudomonas cepacia in lung transplant recipients with cystic fibrosis. Chest. Feb 1993;103(2):466-71. [Medline].
Davis SQ, Garrity ER. Organ allocation in lung transplant. Chest. 2007;132:1646-1651. [Medline].
Egan TM, Kaiser LR, Cooper JD. Lung transplantation. Curr Probl Surg. Oct 1989;26(10):673-751. [Medline].
Marshall SE, Kramer MR, Lewiston NJ. Selection and evaluation of recipients for heart-lung and lung transplantation. Chest. Dec 1990;98(6):1488-94. [Medline].
Meyers BF, Lynch J, Trulock EP. Lung transplantation: a decade of experience. Ann Surg. Sep 1999;230(3):362-70; discussion 370-1. [Medline].
Egan TM, Detterbeck FC, Mill MR. Improved results of lung transplantation for patients with cystic fibrosis. J Thorac Cardiovasc Surg. Feb 1995;109(2):224-34; discussion 234-5. [Medline].
Low DE, Trulock EP, Kaiser LR. Lung transplantation of ventilator-dependent patients. The Washington University Lung Transplantation Group. Chest. Jan 1992;101(1):8-11. [Medline].
Detterbeck FC, Egan TM, Mill MR. Lung transplantation after previous thoracic surgical procedures. Ann Thorac Surg. Jul 1995;60(1):139-43. [Medline].
Guidelines for the determination of death. Report of the medical consultants on the diagnosis of death to the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. JAMA. Nov 13 1981;246(19):2184-6. [Medline].
McWilliams TJ, Williams TJ, Whitford HM, Snell GI. Surveillance bronchoscopy in lung transplant recipients: risk versus benefit. J Heart Lung Transplant. 2008;27:1203-1209. [Medline].
Stewart S, Fishbein MC, Snell GI, Berry GJ, Boehler A, Burke MM, et al. Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection. J Heart Lung Transplant. 2007;26:1229-1242. [Medline].
Knoop C, Haverich A, Fischer S. Immunosuppressive therapy after human lung transplantation. Eur Respir J. Jan 2004;23(1):159-71. [Medline].
Dauber JH, Paradis IL, Dummer JS. Infectious complications in pulmonary allograft recipients. Clin Chest Med. Jun 1990;11(2):291-308. [Medline].
Barr ML, Schenkel FA, Bowdish ME, Starnes VA. Living donor lobar lung transplantation: current status and future directions. Transplant Proc. Nov 2005;37(9):3983-6. [Medline].
Starnes VA, Bowdish ME, Woo MS. A decade of living lobar lung transplantation: recipient outcomes. J Thorac Cardiovasc Surg. Jan 2004;127(1):114-22.
Anthonisen NR. Prognosis in chronic obstructive pulmonary disease: results from multicenter clinical trials. Am Rev Respir Dis. Sep 1989;140(3 Pt 2):S95-9. [Medline].
Arcasoy SM, Kotloff RM. Lung transplantation. N Engl J Med. Apr 8 1999;340(14):1081-91. [Medline].
Bando K, Armitage JM, Paradis IL. Indications for and results of single, bilateral, and heart-lung transplantation for pulmonary hypertension. J Thorac Cardiovasc Surg. Dec 1994;108(6):1056-65. [Medline].
Brunsting LA, Lupinetti FM, Cascade PN. Pulmonary function in single lung transplantation for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg. May 1994;107(5):1337-44; discussion 1344-5. [Medline].
Date H, Triantafillou AN, Trulock EP. Inhaled nitric oxide reduces human lung allograft dysfunction. J Thorac Cardiovasc Surg. May 1996;111(5):913-9. [Medline].
Egan TM, Bennett LE, Garrity ER. Predictors of death on the UNOS lung transplant waiting list: results of a multivariate analysis. J Heart Lung Transplant. Feb 2001;20(2):242. [Medline].
[Best Evidence] Fergusson DA, Hebert PC, Mazer CD, et al. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med. May 29 2008;358(22):2319-31. [Medline].
Griffith BP, Hardesty RL, Armitage JM. A decade of lung transplantation. Ann Surg. Sep 1993;218(3):310-8; discussion 318-20. [Medline].
Griffith BP, Hardesty RL, Trento A. Heart-lung transplantation: lessons learned and future hopes. Ann Thorac Surg. Jan 1987;43(1):6-16. [Medline].
Hachem RR, Yusen RD, Chakinala MM, Meyers BF, Lynch JP, Aloush AA, et al. A randomized controlled trial of tacrolimus versus cyclosporine after lung transplantation. J Heart Lung Transplant. 2007;26:1012-1018. [Medline].
Higenbottam T, Stewart S, Penketh A. Transbronchial lung biopsy for the diagnosis of rejection in heart-lung transplant patients. Transplantation. Oct 1988;46(4):532-9. [Medline].
Kotloff RM, Zuckerman JB. Lung transplantation for cystic fibrosis: special considerations. Chest. Mar 1996;109(3):787-98. [Medline].
Levine SM, Gibbons WJ, Bryan CL. Single lung transplantation for primary pulmonary hypertension. Chest. Nov 1990;98(5):1107-15. [Medline].
Levine SM, Jenkinson SG, Bryan CL. Ventilation-perfusion inequalities during graft rejection in patients undergoing single lung transplantation for primary pulmonary hypertension. Chest. Feb 1992;101(2):401-5. [Medline].
Levy NT, Liapis H, Eisenberg PR. Pathologic regression of primary pulmonary hypertension in left native lung following right single-lung transplantation. J Heart Lung Transplant. Mar 2001;20(3):381-4. [Medline].
Macdonald P, Mundy J, Rogers P. Successful treatment of life-threatening acute reperfusion injury after lung transplantation with inhaled nitric oxide. J Thorac Cardiovasc Surg. Sep 1995;110(3):861-3. [Medline].
Meyers BF, Lynch JP, Trulock EP. Single versus bilateral lung transplantation for idiopathic pulmonary fibrosis: a ten-year institutional experience. J Thorac Cardiovasc Surg. Jul 2000;120(1):99-107. [Medline].
Meyers BF, Lynch JP, Trulock EP. Single versus bilateral lung transplantation for idiopathic pulmonary fibrosis: a ten-year institutional experience. J Thorac Cardiovasc Surg. Jul 2000;120(1):99-107. [Medline].
Meyers BF, Yusen RD, Guthrie TJ. Outcome of bilateral lung volume reduction in patients with emphysema potentially eligible for lung transplantation. J Thorac Cardiovasc Surg. Jul 2001;122(1):10-7. [Medline].
Montefusco CM, Veith FJ. Lung transplantation. Surg Clin North Am. Jun 1986;66(3):503-15. [Medline].
Panos RJ, Mortenson RL, Niccoli SA. Clinical deterioration in patients with idiopathic pulmonary fibrosis: causes and assessment. Am J Med. Apr 1990;88(4):396-404. [Medline].
Pasque MK, Trulock EP, Kaiser LR. Single-lung transplantation for pulmonary hypertension. Three-month hemodynamic follow-up. Circulation. Dec 1991;84(6):2275-9. [Medline].
Sanchez JL, Kruger RM, Paranjothi S. Relationship of cytomegalovirus viral load in blood to pneumonitis in lung transplant recipients. Transplantation. Aug 27 2001;72(4):733-5. [Medline].
Schafers HJ, Wagner TO, Demertzis S. Preoperative corticosteroids. A contraindication to lung transplantation?. Chest. Nov 1992;102(5):1522-5. [Medline].
Snell GI, Westall GP. Immunosuppression for lung transplantation: evidence to date. Drugs. 2007;67:1531-1539. [Medline].
Sundaresan RS, Shiraishi Y, Trulock EP. Single or bilateral lung transplantation for emphysema?. J Thorac Cardiovasc Surg. Dec 1996;112(6):1485-94; discussion 1494-5. [Medline].
Technique of successful clinical double-lung transplantation. Patterson G, Cooper J, Goldman B, Weisel RD, Pearson FG, Waters PF, Todd TR, Scully H, Goldberg M, Ginsberg RJ. Ann Thorac Surg. 1988;45:626-633. [Medline].
Thabut G, Brugiere O, Leseche G. Preventive effect of inhaled nitric oxide and pentoxifylline on ischemia/reperfusion injury after lung transplantation. Transplantation. May 15 2001;71(9):1295-300. [Medline].
Theodore J, Starnes VA, Lewiston NJ. Obliterative bronchiolitis. Clin Chest Med. Jun 1990;11(2):309-21. [Medline].
Toronto Lung Transplant Group. Unilateral lung transplantation for pulmonary fibrosis. Toronto Lung Transplant Group. N Engl J Med. May 1 1986;314(18):1140-5. [Medline].
Trulock EP. Lung transplantation for alpha 1-antitrypsin deficiency emphysema. Chest. Dec 1996;110(6 Suppl):284S-294S. [Medline].
Trulock EP 3rd. Lung Transplantation for COPD. Chest. Apr 1998;113(4 Suppl):269S-276S. [Medline].
Trulock EP, Egan TM, Kouchoukos NT. Single lung transplantation for severe chronic obstructive pulmonary disease. Washington University Lung Transplant Group. Chest. Oct 1989;96(4):738-42. [Medline].
Vizza CD, Yusen RD, Lynch JP. Outcome of patients with cystic fibrosis awaiting lung transplantation. Am J Respir Crit Care Med. Sep 2000;162(3 Pt 1):819-25. [Medline].
Watters LC, King TE, Schwarz MI. A clinical, radiographic, and physiologic scoring system for the longitudinal assessment of patients with idiopathic pulmonary fibrosis. Am Rev Respir Dis. Jan 1986;133(1):97-103. [Medline].
Whitehead B, Helms P, Goodwin M. Heart-lung transplantation for cystic fibrosis. 2: Outcome. Arch Dis Child. Sep 1991;66(9):1022-6; discussion 1016-7. [Medline].
Yankaskas JR, Mallory GB. Lung transplantation in cystic fibrosis: consensus conference statement. Chest. Jan 1998;113(1):217-26. [Medline].
Zuckermann A, Klepetko W. Use of cyclosporine in thoracic transplantation. Transplant Proc. Mar 2004;36(2 Suppl):331S-336S. [Medline].
Further Reading
Keywords
lung transplantation, lung transplant, lung transplant pictures, lung pictures, advanced stage pulmonary disease, chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis (CF), immunosuppression, lung disease, lung disease treatment, lung pictures, lung transplant pictures, lung disease pictures, tacrolimus, FK-506, cyclosporine A, cyclosporin, rejection, organ rejection, lung transplant rejection, bronchiolitis obliterans syndrome, OKT3, ATG, antithrombocyte globulin, forced vital capacity, FVC, FEV1, forced expiratory volume, expiratory volume, pulmonary arterial hypertension, single-lung transplantation, SLT, bilateral sequential lung transplantation, double-lung transplantation, single-lung transplant, double-lung transplant, heart-lung transplant, PEEP, peak end expiratory pressure, DLT, lung surgery
