PMC8660696_01
CT images of five patients pre-lung transplantation and post-lung transplantation. (1A-4A) Progression of bilateral lung fibrosis with consolidation were shown in case 1-4. (1B, 2B, 4B, 5B) Post-lung transplantation CT manifestation without significant abnormality. (3B) Chest imaging showed significant lung effusion and edema in Case 3. (5A) Case 5 suffered deteriorated graft function after 5 years of transplantation and chronic lung allograft dysfunction was suspected.
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F1
These patients survived to date with improved respiratory symptoms and no obvious lung abnormalities on CT images (Figures 1.1B, 4B). Upon follow-up, patient has fully recovered renal function and pulmonary imaging was normal (Figure 1.2B). Cardiac arrhythmia and grade 3 primary graft dysfunction occurred sequentially and could not be wean-off ECMO (Figure 1.3B). Lung function showed FEV1 0.48 L and FVC 1.19L with deteriorating chest imaging of chronic lung allograft dysfunction (Figure 1.5A). Bilateral lung transplantation was performed and postoperative recovery period was uneventful (Figure 1.5B).
Illustration of clinical course and perioperative events in Case 1-4. Pre-lung transplantation and intraoperative mechanical ventilation support, ECMO support modes and duration were illustrated. Post-lung transplantation events were labeled with outcome up to the follow-up date. S, survival; DVT, deep vein thrombosis; AKI, acute kidney injury; POD, post-operation day.
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F2
The clinical course of Case 1-4 are presented in Figure 2.