Thoracoscopic native lung pneumonectomy after single lung transplant: initial experience with 2 cases†

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Transplant Surgery

Background:

• Single lung transplants (SLTs) can lead to complications in the remaining native lung, necessitating intervention.
• Native lung complications (NLCs) post-SLT, though rare, pose significant challenges.
• Surgical options for NLCs are limited, especially in immunosuppressed transplant recipients.

Observation:

• Two cases of NLCs post-SLT are presented: invasive aspergillosis and severe hemoptysis with intraparenchymal hemorrhage.
• Both patients underwent video-assisted thoracoscopic surgery (VATS) pneumonectomy for their respective native lung conditions.
• This represents a novel application of VATS pneumonectomy for managing NLCs.

Findings:

• VATS pneumonectomy was successfully performed in both patients with NLCs.
• The procedure was chosen to potentially improve wound healing and expedite recovery in immunosuppressed individuals.
• Short-term outcomes suggest VATS pneumonectomy is feasible, adequate, and safe in this specific patient cohort.

Implications:

• VATS pneumonectomy is a viable surgical option for managing severe native lung complications after single lung transplantation.
• This minimally invasive technique may offer advantages in recovery for immunosuppressed patients.
• Further research with larger patient series is warranted to confirm these findings and establish long-term efficacy.