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Ann Thorac Surg 1999;68:1892
© 1999 The Society of Thoracic Surgeons

Correspondence

Lung transplantation from a donor sustaining cardiac arrest while running a marathon

Michael W. Frank, MDa, Marc W. Gerdisch, MDa, Edward R. Garrity, Jr, MDa, Edward B.J. Winslow, MDa, Mamdouh Bakhos, MDa

a Loyola University Medical University, 2160 South First Ave, Maywood, IL 60153, USA

To the Editor

We report a case of successful lung transplantation from an unfortunate donor who sustained a cardiac arrest while running a marathon. Cardiac related mortalities during major marathons are rare. Approximately one fatality occurs per year when events from all major marathons are totalled.

A 43-year-old female was running her first marathon. She had never been a smoker, and her medical history was unremarkable only for 3 uncomplicated pregnancies. After running approximately 20 miles she collapsed. She was subsequently brought to a first aid station, and then sustained a cardiac arrest. After a reported 6 to 8 minutes, she was defibrillated twice and resuscitated. She was hemodynamically stabilized with dopamine, levophed, and an intraaortic balloon pump. She never recovered neurologically, and was pronounced brain dead 3 days after her cardiac arrest. Lungs, liver, and kidneys were suitable for donation. Coronary angiography was normal, but cardiac function remained impaired with global hypokinesis on echocardiography. While harvesting the lungs, an absent innominate vein was apparent. Further intraoperative examination of the heart revealed an anomalous left superior vena cava draining into the coronary sinus. Examination for an unroofed coronary sinus was not performed. The donor lungs were ideal for subsequent transplantation.

Bilateral sequential lung transplantation was performed on an 18-year-old female with cystic fibrosis. She had an uncomplicated postoperative course and is doing well 3 months following transplantation.





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Mamdouh Bakhos
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