Lung transplantation for Kartagener syndrome: technical aspects and morphological adaptation of the transplanted lungs

Bridge to second double lung transplant with an extracorporeal carbon dioxide removal system in situs inversus patient

BACKGROUND

Extracorporeal life support use in redo-lung transplant is limited due to poor outcomes. Extracorporeal circulation with a single duo-lumen cannula provides the advantage of more comfortable mobilization particularly in patients in which we expect a longer bridge to transplant.

CASE

A 29-year-old female with Kartagener syndrome and complete situs inversus underwent a double lung transplant for end stage lung disease. Within one year after transplant the patient had primarily hypercapnic respiratory failure with radiographic signs of chronic lung allograft dysfunction. To optimize her nutritional status and muscle strength before re-do lung transplantation, we decided to bridge her with an extracorporeal carbon dioxide removal system due to anatomical difficulty. She was listed and underwent an uneventful re-do double lung transplant with cardiopulmonary support.

CONCLUSIONS

We report a first case with the use of extracorporeal carbon dioxide removal system as a bridge to re-do lung transplant in complete situs inversus patient.