Scoliotic deformity represents a serious spinal disorder that influences the locomotive and cardiopulmonary systems. Some patients with severe scoliosis and end-stage lung disease are therefore denied lung transplantation. In patients with scoliosis considering lung transplantation, size match, straight back syndrome, delayed chest closure and bronchial stenosis are key issues clinicians should evaluate. Therefore, it is vital to determine donor-recipient size matches very precisely. Chest opening is a routine intraoperative primary therapeutic procedure after lung transplantation in unstable patients with oversized transplanted lungs. Postoperative bronchial stenosis occurs predominantly on the right side and is usually handled through interventional bronchoscopy and the insertion of stents. This report describes the complex case of a patient with scoliosis who underwent lobar transplantation in our center.

Department of Anesthesiology and Intensive Care Medicine 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Prague Lung Transplant Program 3rd Department of Surgery 1st Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Zobrazit více v PubMed

Repko M. Diagnostika a terapie skolióz. Med Praxi. 2012;9(2):70–3.

Su JW, Mason DP, Murthy SC, Budev MM, Mehta AC, Goodwin R, Pettersson GB. Successful double lung transplantation in 2 patients with severe scoliosis. J Heart Lung Transplant. 2008;27(11):1262-4. 10.1016/j.healun.2008.07.014. PMID: 18971101. PubMed

Nikkuni E, Hirama T, Ui M, Watanabe T, Mukai S, Watanabe T, Watanabe Y, Oishi H, Ebihara S, Okada Y. Thoracic and vertebral deformities in lung transplantation: perioperative complications and long-term prognoses. BMC Pulm Med. 2024;24(1):347. 10.1186/s12890-024-03168-6. PMID: 39026224; PMCID: PMC11256625. PubMed PMC

Piotrowski JA, Splittgerber FH, Donovan TJ, Ratjen F, Zerkowski HR. Single-lung transplantation in a patient with cystic fibrosis and an asymmetric thorax. Ann Thorac Surg. 1997;64(5):1456–8; discussion 1458–9. 10.1016/S0003-4975(97)00925-9. PMID: 9386721. PubMed

Shiraishi T, Yanagida H, Koga Y, Ohga S, Fujita M, Hiratsuka M, Miyahara S, Waseda R, Sato T, Iwasaki A. Severe scoliosis with an impaired pulmonary allograft function after pediatric unilateral lung transplantation. Gen Thorac Cardiovasc Surg. 2020 Sep 15. 10.1007/s11748-020-01447-7. Epub ahead of print. PMID: 32930959. PubMed

Roach DJ, Szugye NA, Moore RA, Hossain MM, Morales DLS, Hayes D Jr, Towe CT, Zafar F, Woods JC. Improved donor lung size matching by estimation of lung volumes based on chest X-ray measurements. Pediatr Transpl. 2023;27(8):e14594. 10.1111/petr.14594. Epub 2023 Sep 1. PMID: 37655840. PubMed

Raggi P, Callister TQ, Lippolis NJ, Russo DJ. Is mitral valve prolapse due to cardiac entrapment in the chest Cavity? A CT view. Chest. 2000;117(3):636 – 42. 10.1378/chest.117.3.636. PMID: 10712985. PubMed

Betz JW, Oakley PA, Harrison DE. Relief of exertional dyspnea and spinal pains by increasing the thoracic kyphosis in straight back syndrome (thoracic hypo-kyphosis) using CBP® methods: a case report with long-term follow-up. J Phys Ther Sci. 2018;30(1):185–9. Epub 2018 Jan 27. PMID: 29410595; PMCID: PMC5788804. PubMed PMC

Mohite PN, Sabashnikov A, Popov AF, Zeriouh M, Fatullayev J, Capoccia M, Amrani M, Carby M, Simon AR. Delayed chest Closure with skin approximation after lung transplant in Oversized Graft. Exp Clin Transpl. 2018;16(1):107–9. Epub 2017 Jan 31. PMID: 28137205. PubMed

Force SD, Miller DL, Pelaez A, Ramirez AM, Vega D, Barden B, Lawrence EC. Outcomes of delayed chest closure after bilateral lung transplantation. Ann Thorac Surg. 2006;81(6):2020–4; discussion 2024–5. 10.1016/j.athoracsur.2006.01.050. PMID: 16731123. PubMed

Inoue M, Minami M, Ichikawa H, Fukushima N, Shiono H, Utsumi T, Okumura M, Sawa Y. Extracorporeal membrane oxygenation with direct central cannulation followed by delayed chest closure for graft dysfunction after lung transplantation: report of two cases with pulmonary arterial hypertension. J Thorac Cardiovasc Surg. 2007;133(6):1680–1. 10.1016/j.jtcvs.2006.12.074. PMID: 17532992. PubMed

Oliveira HG, Oliveira DM, Greggianin C, Andrade CF, Svartman FM. Biodegradable stent in a patient with recurrent stenosis after lung transplantation. J Bras Pneumol. 2019;45(5):e20190078. 10.1590/1806-3713/e20190078. PMID: 31531618; PMCID: PMC7247767. PubMed PMC

Yamamoto H, Otani S, Miyoshi K, Sugimoto S, Yamane M, Toyooka S. Long-term clinical follow-up after lung transplantation in patient with scoliosis: a case report. Gen Thorac Cardiovasc Surg. 2020 Nov 5. 10.1007/s11748-020-01539-4. Epub ahead of print. PMID: 33155165. PubMed

Garcha PS, Santacruz JF, Machuzak MS, Budev MM, Mehta A. Clinical course after successful double lung transplantation in a patient with severe scoliosis. J Heart Lung Transpl. 2011;30(2):234–5. Epub 2010 Oct 23. PMID: 20971022. PubMed

Lischke R, Pozniak J, Vondrys D, Elliott MJ. Novel biodegradable stents in the treatment of bronchial stenosis after lung transplantation. Eur J Cardiothorac Surg. 2011;40(3):619–24. Epub 2011 Feb 21. PMID: 21334911. PubMed

Fuehner T, Suhling H, Greer M, Wiesner O, Dierich M, Warnecke G, Haverich A, Welte T, Gottlieb J. Biodegradable stents after lung transplantation. Transpl Int. 2013;26(7):e58–60. 10.1111/tri.12095. Epub 2013 Mar 28. PMID: 23551264. PubMed