Abstract
A 25-year-old man who had undergone lung transplantation from a living donor for the treatment of primary pulmonary hypertension was transferred to the ICU with percutaneous cardiopulmonary support (PCPS), because of depressed cardiac function due to the relatively small size of the transplanted lung. He was weaned from the PCPS on post operative day 2, however, mechanical ventilation was continued on account of poor dynamic lung compliance. On post operative day 9, the pulmonary arterial pressure rose, with an increase in the pulmonary/systemic arterial pressure ratio and an unfavorable ventilatory status. As the patient developed pulmonary edema possibly attributable to graft rejection, the PCPS was reinstituted. The elevation in the pulmonary arterial pressure subsided in response to correction of water balance and reduction of cardiac output, and the patient was weaned from the PCPS and mechanical ventilation. A patient with a small-sized lung graft is prone to developing pulmonary edema due to the relatively small size of pulmonary vascular bed. In the case reported herein, the time-course of changes of the pulmonary/systemic blood pressure ratio appeared to reflect the status of the transplanted lung.
