This case highlights the devastating consequences of "stump" dehiscence following lung transplantation.  

The presence of a new or persistent pneumothorax following a transplant should raise the suspicion of airways dehiscence.  First line treatment is directed at sealing the resultant bronchopleural fistula with with endobronchial, VATS, or open adhesive ("stump glue") or clipping.

A contrast CT is typically performed to exclude associated pulmonary arterial or bronchial arterial vascular compromise.  Resultant pulmonary infarction may necessitate a pneumonectomy (as in this case) and carries a poor prognosis.