scholarly journals Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome

2021 ◽  
Vol 8 ◽  
Author(s):  
Guohui Jiao ◽  
Xiangnan Li ◽  
Bo Wu ◽  
Hang Yang ◽  
Guoqing Zhang ◽  
...  
Keyword(s):  
Case Report ◽  
Pulmonary Fibrosis ◽  
Extracorporeal Membrane Oxygenation ◽  
Lung Transplantation ◽  
Clinical Course ◽  
Therapeutic Option ◽  
Bilateral Lung Transplantation ◽  
Irreversible Effects ◽  
Transplantation Center ◽  
Bilateral Lung

Background: Lung transplantation is recognized as the only therapeutic option for patients who develop irreversible pulmonary fibrosis after herbicide intoxication.Methods: We have collected and presented clinical course and outcome of four patients who received lung transplantation due to paraquat and diquat intoxication from 2018 to 2021. Another patient who received initial lung transplantation due to paraquat intoxication and re-transplantation due to chronic lung allograft dysfunction in 2019, was further reported. Patients were admitted in lung transplantation centers, including the 1st affiliated hospital of Zhengzhou University and Wuxi Lung transplantation center. Previous reported cases from Europe, Canada and China were also summarized as benchmark.Results: During the period from the year of 2018 to 2021, there have been four patients in China, who received lung transplantation due to herbicide intoxication. Median age of the four patients was 37 (IQR 34.5, 39.75) years old. Median time from intoxication to lung transplantation was 27.5 (IQR 27, 30.5) days. Bilateral lung transplantation was performed in three patients, while one single lung transplantation was performed in an urgent listed patient. Extracorporeal Membrane Oxygenation (ECMO) and hemopurification support were used in all patients (100%). Details of the cases with follow-ups were further presented and analyzed.Conclusions: Late timing of bilateral lung transplantation can be performed successfully for pulmonary fibrosis after paraquat or diquat intoxication. The survival of patients with complex perioperative conditions can be achieved with a multidisciplinary team to manage the irreversible effects of intoxication.

Survival After Single Versus Bilateral Lung Transplantation for High-Risk Patients With Pulmonary Fibrosis

2009 ◽  
Vol 88 (5) ◽  
pp. 1616-1626 ◽  
Author(s):  
Eric S. Weiss ◽  
Jeremiah G. Allen ◽  
Christian A. Merlo ◽  
John V. Conte ◽  
Ashish S. Shah
Keyword(s):  
High Risk ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
High Risk Patients ◽  
Bilateral Lung Transplantation ◽  
Risk Patients ◽  
Bilateral Lung ◽  
Single Versus

scholarly journals Normalization of Elevated Tumor Marker CA27-29 After Bilateral Lung Transplantation in a Patient With Breast Cancer and Idiopathic Pulmonary Fibrosis

2018 ◽  
Vol 26 (3) ◽  
pp. 515-518
Author(s):  
Mehmet Sitki Copur ◽  
Julie Marie Wurdeman ◽  
Debra Nelson ◽  
Ryan Ramaekers ◽  
Dron Gauchan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Tumor Marker ◽  
Tumor Markers ◽  
Early Stage ◽  
Serum Tumor Marker ◽  
Normal Range ◽  
Bilateral Lung Transplantation ◽  
Bilateral Lung

Solid tumors involving glandular organs express mucin glycoprotein that is eventually shed into the circulation. As a result, these proteins can easily be measured in the serum and be used as potential tumor markers. The most commonly used tumor markers for breast cancer are CA27-29 and CA15-3, which both measure the glycoprotein product of the mucin-1 (MUC1) gene. CA27-29 has been approved by the US Food and Drug Administration for monitoring disease activity in breast cancer patients. Most oncology clinical practice guidelines do not recommend the use of tumor markers for routine surveillance of early stage disease but recognize their utility in the metastatic setting. We present a patient with stage IIIA breast cancer and preexisting hypersensitivity pneumonitis who was found to have an elevated serum tumor marker CA27-29. After successful curative intent treatment of her early stage breast cancer, she developed gradual and progressive worsening of her lung disease with eventual development of severe pulmonary fibrosis requiring bilateral lung transplantation. As part of the pretransplant evaluation, she was found to have an elevation of serum tumor marker CA27-29. While the diagnostic evaluation, including imaging studies, was negative for the presence of recurrent disease, the serial serum tumor marker CA27-29 levels remained persistently elevated. The decision was made for her to undergo bilateral lung transplantation. Shortly after surgery, her CA27-29 tumor marker level returned to normal range, and it has continued to remain in the normal range with no evidence of breast cancer recurrence.

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