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Case Reports
. 2022 Jan 3;16(1):2.
doi: 10.1186/s13256-021-03191-9.

Acute worsening of native lung fibrosis after single lung transplantation for pulmonary fibrosis: two case reports

Tiphaine Goletto  1   2 , Sixtine Decaux  1   2 , Vincent Bunel  1   2 , Gaëlle Weisenburger  1   2 , Jonathan Messika  1   2 , Samer Najem  1   2 , Chahine Medraoui  1   2 , Cendrine Godet  1   2 , Marie Pierre Debray  3 , Brice Lortat-Jacob  4 , Pierre Mordant  5 , Yves Castier  5 , Lila Bouadma  6 , Raphael Borie  7 , Hervé Mal  8   9   10
Affiliations
Case Reports

Acute worsening of native lung fibrosis after single lung transplantation for pulmonary fibrosis: two case reports

Tiphaine Goletto et al. J Med Case Rep. .

Abstract

Background: In patients receiving single lung transplantation for idiopathic pulmonary fibrosis, worsening of fibrosis of the native lung is usually progressive over time, with no significant effects on gas exchange.

Case presentation: Here, we describe the cases of two Caucasian male recipients of single lung transplants for idiopathic pulmonary fibrosis, 65 and 62 years of age, who exhibited acute worsening of lung fibrosis after an episode of serious viral infection (cytomegalovirus primo-infection in one case and COVID-19 in the other). In both cases, along with opacification of the native lung over several days, the patients presented acute respiratory failure that required the use of high-flow nasal oxygen therapy. Eventually, hypoxemic respiratory failure resolved, but with rapid progression of fibrosis of the native lung.

Conclusion: We conclude that acute worsening of fibrosis on the native lung secondary to a severe viral infection should be added to the list of potential complications developing on the native lung after single lung transplantation for idiopathic pulmonary fibrosis.

Keywords: Hypoxemia; Idiopathic pulmonary fibrosis; Lung fibrosis; Lung infection; Lung transplantation.

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Conflict of interest statement

TG, SD, VB, GW, JM, SN, C M, CG, MPD, BLJ, PM, YC, and LB have nothing to disclose. Dr Borie reports personal fees from Boehringer, Roche, and Sanofi; support for attending meetings from Boehringer, Roche, and Chiesi; Dr. Mal reports personal fees from Boehringer, personal fees from Novartis, nonfinancial support from Pulmonx, outside the submitted work.

Figures

Fig. 1
Fig. 1
CT of the thorax in patient 1, a 65-year-old man, at various times after right single lung transplantation (SLT) for idiopathic pulmonary fibrosis (IPF). A Day 7 after hospital admission (day 1) for management of CMV infection in a patient with CMV mismatch. B Day 14, 1 day before the patient developed acute respiratory failure (ARF) requiring a transfer to the intensive care unit (ICU) on day 16. C Day 19, while in the ICU for ARF. D Day 27, 1 day before discharge from the ICU. E Day 63, well after the ARF episode.
Fig. 2
Fig. 2
CT of the thorax in patient 2, a 62-year-old man, at different times after right SLT for IPF. A Postoperative day (POD) 90, before SARS-CoV-2 infection. B POD 104, when SARS-CoV-2 infection was diagnosed. C POD 110, at the time of transfer to the ICU for ARF. D POD 135, after discharge from the ICU. E POD 170 after discharge from the hospital.
See this image and copyright information in PMC

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