Donor-acquired fat embolism causing primary organ failure after lung transplantation

Technically successful bilateral sequential lung transplantation in a 40-year-old man was complicated by the immediate development of pulmonary edema on reperfusion of the allograft. Death resulted within 12 hours and was caused by the fat embolism syndrome confirmed on premortem open-lung biopsy. The donor had satisfied current selection criteria but had sustained a femoral and multiple rib fractures. This case highlights the potential risks of transplanting lungs from traumatic donors and the deficiencies in current methods of donor assessment.