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Ann Thorac Surg 2007;84:e4-e5
© 2007 The Society of Thoracic Surgeons

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Case Reports

Donor Fat Embolism and Primary Graft Dysfunction After Lung Transplantation

^a Department of Thoracic Surgery, Lung Transplant—Cystic Fibrosis Unit, La Fe University Hospital, Valencia, Spain
^b Department of Pathology, La Fe University Hospital, Valencia, Spain

Accepted for publication April 11, 2007.

^_* Address correspondence to Dr Padilla, Servicio de Cirugía Torácica, Unidad de Trasplante Pulmonar—Fibrosis Quística, Hospital Universitario La Fe, Avenida de Campanar 21, Valencia, 46009, Spain (Email: jpadilla{at}comv.es).

Primary lung graft dysfunction is one of the major causes of perioperative morbidity and mortality in lung transplantation. Primary lung graft dysfunction is a clinical syndrome occurring in the immediate postoperative period after lung transplantation and is characterized by severe hypoxemia, pulmonary edema, and pulmonary infiltrates on chest x-ray film, requiring that the patient remain intubated and thus favoring pulmonary infection, sepsis, and subsequent multiple organ failure in the transplanted patient. It has recently been shown that unexpected pulmonary embolism is relatively common in the donor and is associated with primary lung graft dysfunction. However, we believe that only one case of primary lung graft dysfunction due to pulmonary fat embolism has been documented histologically in patients undergoing lung transplantation. The objective of this study is to report our experience with a case of primary lung graft dysfunction due to fat embolism in the donor lung detected in the morphologic study.