Patient 2
A 35year-old male with cystic fibrosis (CF) had a recurrent history of
hemoptysis as well as infectious exacerbations in the past. Due to these
exacerbations, the patient developed a retracted right lung with
concurrent right sided mediastinal shift (Figure 2A ). He
underwent a sequential double lung transplantation on cardiopulmonary
bypass support. Due to intraoperative coagulopathy and size mismatch, we
elected to perform a delayed closure on POD 2 in the OR after a chest
washout with antibiotics. No donor lung volume reduction was necessary
to close his chest. His hospital course was complicated with respiratory
insufficiency requiring tracheostomy and acute kidney injury requiring
renal replacement therapy. Prior to being discharged on POD 52, his
tracheostomy was decannulated and his kidney function returned to normal
levels. Both lungs were fully expanded, and the mediastinum was
centered. (Figure 2B )