Small recipient chest cavity from fibrotic lung disease in lung transplantation: Physiology matters
Michael Eberlein,
Robert M. Reed,
Kamel Gharaibeh,
Ananth Charya,
Alison Grazioli,
Reney Henderson,
Alexander S. Krupnick,
Gregory Bittle
Affiliations
Michael Eberlein
Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, Maryland; Corresponding author: Michael Eberlein, Division of Pulmonary and Critical Care Medicine, 29 Greene St, Rm 430, Baltimore, MD 21221.
Robert M. Reed
Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, Maryland
Kamel Gharaibeh
Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, Maryland
Ananth Charya
Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, Maryland
Alison Grazioli
Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, Maryland
Reney Henderson
Division of Cardiothoracic Anesthesia, University of Maryland School of Medicine, Baltimore, Maryland
Alexander S. Krupnick
Division of Thoracic Surgery, University of Maryland School of Medicine, Baltimore, Maryland
Gregory Bittle
Division of Thoracic Surgery, University of Maryland School of Medicine, Baltimore, Maryland
Lung transplantation is an established management strategy for advanced end-stage lung disease with the goal of restoring normal pulmonary physiology. This principle guided our management approach to the clinical challenge of a lung transplant recipient with a small chest cavity from fibrotic lung disease. Size matching should occur based on the recipient’s predicted total lung capacity, which best reflects the recipient’s normal chest cavity size. We present an instructive case that suggests that the small chest cavity size adjusts relatively quickly toward normal once the fibrotic lungs are removed, and normal allograft is implanted.
