Bronchiectasis and pulmonary fibrosis of the surrounding parenchyma can
result from recurrent infection and inflammation. A portion of these
patients can present with complete destruction of their lung parenchyma,
retraction of the chest cavity and concurrent mediastinal shift. In some
cases, lung transplantation is the final option once the reduction of
lung capacity becomes clinically detrimental. Concerns with mediastinal
shift and chest wall retraction may limit the indication of a double
lung transplant in these patients. We report the outcomes as well as
preoperative and operative management in two patients with significant
lung volume reduction and mediastinal shift due to bronchiectasis of the
right lung. Both patients underwent sequential double lung
transplantation due to lung failure.