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Case Reports
. 2019 Mar 1:7:2050313X19834155.
doi: 10.1177/2050313X19834155. eCollection 2019.

Transplantation of a three-lobed donor left lung: A case report

Samuel Jacob  1 , Ian A Makey  1 , Magdy M El-Sayed Ahmed  1   2 , Jorge M Mallea  3 , David B Erasmus  3 , Erol V Belli  1
Affiliations
Case Reports

Transplantation of a three-lobed donor left lung: A case report

Samuel Jacob et al. SAGE Open Med Case Rep. .

Abstract

A true left middle lobe (lingular lobe) is very rare, but accessory fissures can be unexpectedly found at transplant. Pre-transplant knowledge of accessory lobes and accessory fissures aids in preparation, transplantation, postoperative assessment, and long-term care planning; however, fissures and accessory lobes can be overlooked by radiologists during routine evaluation of images. Here, we describe the first left lung with three anatomical lobes that was successfully transplanted into a 63-year-old patient with idiopathic pulmonary fibrosis. This anatomical variation did not change our surgical plan or technique, but surgeons should be aware of this possibility, especially when planning postoperative care.

Keywords: Lung; organ donor management; transplantation.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Left posterolateral thoracotomy. Intraoperative image showing the deflated left lung and its three lobes.
Figure 2.
Figure 2.
Postoperative bronchoscopic image showing the three-lobed bronchus of left lung: A, upper bronchus; B, middle accessory lob bronchus; and C, lower lob bronchus.
Figure 3.
Figure 3.
(a) Post-transplant computed tomographic image showing the three lobes of the left lung: 1, upper lob; 2, middle accessory lob bronchus; and 3, lower lob. (b) Normal variant of left lung: 1, upper lob and 2, lower lob.
See this image and copyright information in PMC

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