Retransplantation for COVID-19-related lung graft failure: A case report of successful outcome in a critically ill lung transplant recipient.

End-stage lung disease from nonrecovered COVID-19 acute respiratory distress syndrome has become an increasingly frequent indication for lung transplant. Although reports of lung transplant recipients (LTRs) with COVID-19 suggest an increased risk for hospitalization, respiratory failure, and death, little is known about retransplant for COVID-19-related lung graft failure. In this manuscript, we present a 49-year-old man who received bilateral lung retransplantation for COVID-19-related lung graft failure, 7½ years after his initial transplant for idiopathic pulmonary fibrosis. Our case suggests that retransplantation may be a viable option for critically ill LTRs with COVID-19-related graft failure, even in the presence of other organ dysfunction, provided that they are in good condition and have an immunologically favorable donor.

Spontaneous pneumothorax in a single lung transplant recipient-a blessing in disguise: A case report.

BACKGROUND: End-stage chronic obstructive pulmonary disease (COPD) is one of the common lung diseases referred for lung transplantation. According to the international society of heart and lung transplantation, 30% of all lung transplantations are carried out for COPD alone. When compared to bilateral lung transplant, single-lung transplant (SLT) has similar short-term and medium-term results for COPD. For patients with severe upper lobe predominant emphysema, lung volume reduction surgery is an excellent alternative which results in improvement in functional status and long-term mortality. In 2018, endobronchial valves were approved by the Food and Drug Administration for severe upper lobe predominant emphysema as they demonstrated improvement in lung function, exercise capacity, and quality of life. However, the role of endobronchial valves in native lung emphysema in SLT patients has not been studied. CASE SUMMARY: We describe an unusual case of severe emphysema who underwent a successful SLT 15 years ago and had gradual worsening of lung function suggestive of chronic lung allograft dysfunction. However, her lung function improved significantly after a spontaneous pneumothorax of the native lung resulting in auto-deflation of large bullae. CONCLUSION: This case highlights the clinical significance of native lung hyperinflation in single lung transplant recipient and how spontaneous decompression due to pneumothorax led to clinical improvement in our patient.