Presentation
2 hours post lung transplant. Difficulty ventilating patient.
Patient Data
Age: 55 years
Gender: Female
From the case:
Hyperacute lung transplant rejection
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Lines and tubes: ETT, 2x right jugular CVLs, 2x mediastinal drains, bilateral ICCs, IVC ECMO catheter.
Multiple surgical clips and packs.
Diffuse complete whiteout of both lungs with air bronchograms.
Case Discussion
Massive white out of both lungs in the immediate (hours) post-op period following lung transplantation is in keeping with hyperacute transplant rejection. This is a rare complication that is due to the release of preformed recipient antibodies against the allograft which leads to fulminant pulmonary edema. The patient dies 8 hours later. Autopsy confirmed severe pulmonary edema.
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