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Volume: 6 Issue: 4 November 2008 - Supplement - 1

FULL TEXT

BONE AND FAT EMBOLIZATION IN DONOR AS THE CAUSE OF DEATH IN LUNG RECIPIENT; REPORT OF ONE CASE

The cause of death in organ donors may have a great impact on organ recipients' outcome. Trauma is the prevailing cause of death in brain dead patients in Iran and many other countries. Such patients may have many complications, among them vascular embolization with fat and other tissues. We describe here a case of vascular embolization in donor and its consequence on the recipient’s outcome. The recipient was a 36 years-old woman with pulmonary fibrosis. She received a single lung transplant from a brain dead patient with who died because trauma. Donor had no obvious fractures and the oxygen challenge test was ideal. The harvested lung was normal in bronchoscopy and was clear in plain chest radiography. The day after lung transplantation, the recipient was extubated successfully. O2 saturation was normal. In CT-Scan, There was a fixed infiltration in the base of the transplanted lung. In day 5 post-transplantation, the infiltration got expanded and patient developed acute respiratory distress syndrome (ARDS). Patient's condition deteriorated rapidly and he died on day 10 of transplantation due to ARDS. The pathology result for the brain dead patient, which was obtained from another patient's lung, got ready after the recipient's death and showed massive vascular fat and bone embolization. In the mentioned case, all criteria for lung harvest from brain dead patient were met. Looking for embolization is not among the criteria for lung transplantation if chest radiography is clear and O2 challenge test is acceptable, but we observed a poor outcome in recipient due to bone and fat embolization of the donor's lung. Such complications when transplanting from a traumatic patients should be kept in mind.



Volume : 6
Issue : 4
Pages : 113


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Transplant Research Center, Massih Daneshvari Hospital, Darabad-Niavaran, Tehran, Iran