scholarly journals Acute worsening of native lung fibrosis after single lung transplantation for pulmonary fibrosis: two case reports

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Tiphaine Goletto ◽  
Sixtine Decaux ◽  
Vincent Bunel ◽  
Gaëlle Weisenburger ◽  
Jonathan Messika ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Viral Infection ◽  
Lung Fibrosis ◽  
Case Reports ◽  
Rapid Progression ◽  
Single Lung Transplantation ◽  
Native Lung

Abstract Background In patients receiving single lung transplantation for idiopathic pulmonary fibrosis, worsening of fibrosis of the native lung is usually progressive over time, with no significant effects on gas exchange. Case presentation Here, we describe the cases of two Caucasian male recipients of single lung transplants for idiopathic pulmonary fibrosis, 65 and 62 years of age, who exhibited acute worsening of lung fibrosis after an episode of serious viral infection (cytomegalovirus primo-infection in one case and COVID-19 in the other). In both cases, along with opacification of the native lung over several days, the patients presented acute respiratory failure that required the use of high-flow nasal oxygen therapy. Eventually, hypoxemic respiratory failure resolved, but with rapid progression of fibrosis of the native lung. Conclusion We conclude that acute worsening of fibrosis on the native lung secondary to a severe viral infection should be added to the list of potential complications developing on the native lung after single lung transplantation for idiopathic pulmonary fibrosis.

scholarly journals Lung transplantation for patients with severe COVID-19

2020 ◽  
Vol 12 (574) ◽  
pp. eabe4282 ◽  
Author(s):  
Ankit Bharat ◽  
Melissa Querrey ◽  
Nikolay S. Markov ◽  
Samuel Kim ◽  
Chitaru Kurihara ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Single Cell ◽  
Rna Sequencing ◽  
Lung Tissue ◽  
Single Molecule ◽  
Sequencing Data ◽  
Native Lung ◽  
Single Cell Rna Sequencing

Lung transplantation can potentially be a life-saving treatment for patients with nonresolving COVID-19–associated respiratory failure. Concerns limiting lung transplantation include recurrence of SARS-CoV-2 infection in the allograft, technical challenges imposed by viral-mediated injury to the native lung, and the potential risk for allograft infection by pathogens causing ventilator-associated pneumonia in the native lung. Additionally, the native lung might recover, resulting in long-term outcomes preferable to those of transplant. Here, we report the results of lung transplantation in three patients with nonresolving COVID-19–associated respiratory failure. We performed single-molecule fluorescence in situ hybridization (smFISH) to detect both positive and negative strands of SARS-CoV-2 RNA in explanted lung tissue from the three patients and in additional control lung tissue samples. We conducted extracellular matrix imaging and single-cell RNA sequencing on explanted lung tissue from the three patients who underwent transplantation and on warm postmortem lung biopsies from two patients who had died from COVID-19–associated pneumonia. Lungs from these five patients with prolonged COVID-19 disease were free of SARS-CoV-2 as detected by smFISH, but pathology showed extensive evidence of injury and fibrosis that resembled end-stage pulmonary fibrosis. Using machine learning, we compared single-cell RNA sequencing data from the lungs of patients with late-stage COVID-19 to that from the lungs of patients with pulmonary fibrosis and identified similarities in gene expression across cell lineages. Our findings suggest that some patients with severe COVID-19 develop fibrotic lung disease for which lung transplantation is their only option for survival.

scholarly journals Exacerbation of Pulmonary Fibrosis Following Single Lung Transplantation

2012 ◽  
Vol 19 (1) ◽  
pp. e3-e4 ◽  
Author(s):  
Dawei Yang ◽  
Jennifer M Wilson ◽  
Chunxue Bai ◽  
John Yee ◽  
Pearce G Wilcox ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Acute Exacerbation ◽  
Thromboembolic Disease ◽  
Single Lung Transplantation ◽  
Maintenance Immunosuppression ◽  
Native Lung ◽  
Acute Exacerbations

Acute exacerbations of interstitial lung disease present as clinical deteriorations, with progressive hypoxemia and parenchymal consolidation not related to infection, heart failure or thromboembolic disease. Following single lung transplantation, patients receive maintenance immunosuppression, which could mitigate the development of acute exacerbations in the native lung. A 66-year-old man with fibrotic, nonspecific interstitial pneumonitis presented with fever, hypoxemia and parenchymal consolidation limited to the native lung four years after single lung transplantation. Investigations were negative for infection, heart failure and thromboembolic disease. The patient worsened over the course of one week despite broad-spectrum antimicrobial therapy, but subsequently improved promptly with augmentation of prednisone dosed to 50 mg daily and addition of N-acetylcysteine. Hence, the patient fulfilled the criteria for a diagnosis of an acute exacerbation of pulmonary fibrosis in his native lung. Clinicians should consider acute exacerbation of parenchymal lung disease of the native lung in the differential diagnosis of progressive respiratory deterioration following single lung transplantation for pulmonary fibrosis.

scholarly journals Association of circulating cell-free double-stranded DNA and metabolic derangements in idiopathic pulmonary fibrosis

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-217315
Author(s):  
William Whalen ◽  
Mustafa Buyukozkan ◽  
Bethany Moore ◽  
Jong-Seok Moon ◽  
Charles S Dela Cruz ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Fibrosis ◽  
Amino Acid Metabolism ◽  
Acid Metabolism ◽  
Rapid Progression ◽  
Healthy Controls ◽  
Double Stranded Dna ◽  
Slow Progressors ◽  
Progression Of Disease

Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease with unclear aetiology and poorly understood pathophysiology. Although plasma levels of circulating cell-free DNA (ccf-DNA) and metabolomic changes have been reported in IPF, the associations between ccf-DNA levels and metabolic derangements in lung fibrosis are unclear. Here, we demonstrate that ccf-double-stranded DNA (dsDNA) is increased in patients with IPF with rapid progression of disease compared with slow progressors and healthy controls and that ccf-dsDNA associates with amino acid metabolism, energy metabolism and lipid metabolism pathways in patients with IPF.

Bilateral versus single lung transplantation for idiopathic pulmonary fibrosis

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
S Lehmann ◽  
S Leontyev ◽  
J Garbade ◽  
MJ Barten ◽  
P von Samson ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Single Lung Transplantation

scholarly journals Progression of native lung fibrosis in lung transplant recipients with idiopathic pulmonary fibrosis

2010 ◽  
Vol 104 (3) ◽  
pp. 426-433 ◽  
Author(s):  
Brett M. Elicker ◽  
Jeffrey A. Golden ◽  
Karen G. Ordovas ◽  
Lorriana Leard ◽  
Todd R. Golden ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Fibrosis ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Native Lung ◽  
Lung Transplant Recipients

scholarly journals Native lung hyperinflation after single lung transplantation – case report and literature review

2021 ◽  
Author(s):  
Kajetan Kiełbowski ◽  
Nikola Ruszel ◽  
Seweryn Skrzyniarz ◽  
Maria Piotrowska ◽  
Tomasz Grodzki ◽  
...  
Keyword(s):  
Case Report ◽  
Lung Transplantation ◽  
World Literature ◽  
Case Reports ◽  
Pulmonary Diseases ◽  
Chronic Obstructive ◽  
Single Lung Transplantation ◽  
Lung Hyperinflation ◽  
Native Lung ◽  
End Stage

Introduction: Single lung transplantation (SLuTx) is a challenging operation for patients with end-stage chronic pulmonary diseases. After surgery, native lung hyperinflation (NLH) and a mediastinal shift may develop, which changes the anatomical position of the lungs and heart and may lead to graft compression. Aim: We present a case report of a patient who developed NLH after SLuTx. We discuss the treatment methods and compare the outcomes with other case reports and analysis from world literature. Case study: A 56-year-old female patient was diagnosed with end-stage chronic obstructive pulmonary disease (FEV1 < 30%) and qualified for right SLuTx. After the procedure, spirometry revealed gradual loss in FEV1. Radiological images confirmed NLH and compression of the graft. Therefore, a native lung pneumonectomy was performed with positive outcomes. Results and discussion: NLH is a known complication of SLuTx. Typically, lung volume reduction surgery is performed to reduce the compression and a pneumonectomy is a rare treatment, even in centres with extensive experience with SLuTx. Conclusions: Despite SLuTx being a common approach in many pulmonary diseases, NLH should be always taken into consideration. Hyperinflation could cause a dangerous loss of respiratory efficiency and require invasive surgeries for lung transplant recipients.

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