Search

We report the first case of coronavirus disease 2019 (COVID-19)-associated respiratory failure requiring urgent living-donor lobar lung transplantation (LDLLTx). A 57-year-old woman with a positive viral status developed severe hypoxia requiring extracorporeal membrane oxygenation (ECMO). Her respiratory function deteriorated, with almost totally collapsed lungs. All of her other organs functioned well. After 104 days on ECMO, she received urgent LDLLTx under cardiopulmonary bypass. The grafts worked well, and she was weaned off cardiopulmonary bypass after reperfusion. LDLLTx is an option for selected patients with post-COVID-19 end-stage respiratory failure. Coronavirus disease 2019 (COVID-19) has spread worldwide since December 2019 due to the unprecedented pandemic.1 Patients with end-stage COVID-19-related respiratory failure require mechanical ventilation and/or extracorporeal membrane oxygenation (ECMO). In some countries, lung transplantation (LTx) has become a treatment option for irreversible lung function deterioration.2,3 We report the first successful case of severe respiratory failure caused by COVID-19 treated with urgent living-donor lobar lung transplantation (LDLLTx).

Background Pulmonary pseudoaneurysm (PPA) is a potentially lethal complication of lung resection with a high risk of recurrence after endovascular coiling. Case presentation We report a case in which recurrent hemoptysis due to PPA after left lower lobe sleeve resection was treated by endovascular embolization of the left main pulmonary artery as a salvage treatment. The first hemoptysis was managed by endovascular coil embolization with extracorporeal membrane oxygenation, but refractory hemorrhage occurred 3 months later due to penetration of the endovascular coil into the bronchial anastomosis site. Because left completion pneumonectomy was considered too high risk, the left main pulmonary artery was palliatively embolized using an Amplatzer vascular plug (St. Jude Medical, MN, USA) to totally disrupt the left pulmonary arterial flow. Conclusions Total embolization of the left main pulmonary artery for repeated PPA rupture may be useful as a palliative treatment in patients unable to tolerate pneumonectomy.