Single lung transplantation for alveolar microlithiasis: the first clinical experience

Pulmonary alveolar microlithiasis[P. A. M.] is a rare pulmonary disorder that pursues usually an asymptomatic course and can culminate in severe respiratory failure. We report a 48year old Saudi female patient with P. A. M. who deteriorated rather steadily after the initial 18 years of asympotomatic course until a frank type I respiratory failure is established. Single lung transplantation [S. L. T.]was performed successfully and the patient returned to full daily activity and has now survived 12 months post S. L. The immunosuppression consisted of Cyclosporine-A 10 mg/kg/day, azathioprine [Immuran] 2mg/kg/day and perdnisolone 10 m. daily. The bronchial anastomosis was done by telescoping the recipient and donor main bronchus without omental wrap. A significant bronchial stricture of the anastomotic site occurred 4 months post S. L. T. which was dilated endoscopically with good clinical and bronchoscopic result. No episodes of rejection or infection were encountered so far