Long-term survival of bilateral lung transplantation combined with Nuss operation on treatment of bronchiolitis obliterans syndrome complicated with thoracic deformity after hematopoietic stem cell transplantation: report of one case
10.3969/j.issn.1674-7445.2018.04.005
- VernacularTitle:双肺移植同期Nuss手术治疗造血干细胞移植术后闭塞性细支气管炎综合征合并胸廓畸形长期生存1例
- Author:
Hao DING
1
;
Wenjun MAO
;
Feng LIU
;
Li FAN
;
Jingyu CHEN
Author Information
1. 南京医科大学附属无锡市人民医院胸外科暨肺移植中心
- Keywords:
Lung transplantation;
Hematopoietic stem cell transplantation;
Bronchiolitis obliterans;
Correction surgery;
Thoracic deformity;
Pectus excavatum;
Extracorporeal membrane oxygenation
- From:
Organ Transplantation
2018;9(4):268-271,277
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of bilateral lung transplantation combined with Nuss operation on the treatment of bronchiolitis obliterans syndrome (BOS) complicated with pectus excavatum after hematopoietic stem cell transplantation. Methods On March 24, 2015, one patient presenting with BOS complicated with pectus excavatum after hematopoietic stem cell transplantation underwent extracorporeal membrane oxygenation (ECMO)-assisted bilateral lung transplantation in the Department of Thoracic Surgery and Lung Transplantation Center of Wuxi People's Hospital affiliated to Nanjing Medical University. Simutaneously, Nuss operation was successfully performed to treat pectus excavatum. After anti-inflammation and anti-fungal treatment, a triple immunosuppressive regimen consisting of tacrolimus + mycophenolate mofetil + adrenocortical hormone was implemented. Results The patient was properly recovered and discharged on 25 d after operation. The Nuss steel plate was removed from the chest at postoperative 2 years. The thoracic deformity was corrected. The patient received long-term postoperative follow-up. Until submission date, the patient survived for more than 3 years. The lung function was well restored and the quality of life was satisfactory. Conclusions Bilateral lung transplantation combined with Nuss operation is an effective approach in the treatment of end-stage BOS complicated thoracic deformity.