Simultaneous bilateral lung and pancreas transplantation in recipient with cystic fibrosis

Transplant Proc. 2008 Mar;40(2):494-7. doi: 10.1016/j.transproceed.2008.01.010.


Introduction: Cystic fibrosis (CF) is an inherited disorder that presents in childhood as a multisystem disease. Pulmonary failure and pancreatic insufficiency, including CF-related diabetes (CFRD) and exocrine insufficiency, are significant causes of morbidity and mortality in these patients. In this report we have reviewed our experience with a simultaneous lung and pancreas transplantation in a patient with CF.

Methods: The recipient was a 25-year-old man with CF complicated by bronchiectasis with recurrent episodes of pneumonia, pancreatic exocrine insufficiency, and CFRD. He had normal hepatic and renal function.

Surgical technique: The lung and pancreas allografts were procured from a single cadaveric donor. The double lung transplantation was performed through separate thoracic incisions. The pancreas transplantation was performed through a midline incision with systemic venous drainage and proximal enteric exocrine drainage.

Results: The recipient recovered well from his transplantation with early extubation. The pancreas allograft functioned well with normal blood glucose independent of insulin. As a result of the enteric drainage of the pancreas allograft, the patient no longer required supplemental pancreatic enzymes. His postoperative course was complicated by distal intestinal obstruction, a complex wound infection, and reversible leukoencephalopathy. At 1-year posttransplantation he remains free of supplemental oxygen, insulin, and pancreatic enzyme replacement.

Conclusion: Simultaneous lung and pancreas transplantation in a patient with CF was performed safely, providing the advantages of normalization of glucose and improved nutrition for a patient requiring lung transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / surgery*
  • Humans
  • Lung Transplantation* / methods
  • Male
  • Pancreas Transplantation* / methods
  • Pulmonary Fibrosis / etiology
  • Pulmonary Fibrosis / surgery
  • Transplantation, Homologous / methods
  • Treatment Outcome