Q: 58 year old male who underwent Left single lung transplant for idiopathic pulmonary fibrosis (IPF) about 2 days ago, developed shortness of breath(SOB) and found to have pneumothorax(PTX) on Right side. 'Pneumocath' resolved the PTX. What would be the further management?


Answer: Interestingly, after single lung transplantation, secondary spontaneous pneumothoraces have been reported on contralateral side. Important point to remember is that these secondary spontaneous pneumothoraces are prone to recur and requires further step beyond chest tube insertion. Obliteration of pleural space via any appropriate method like  talc pleurodesis should be strongly considered.


 References: 

1.  Spaggiari L, Rusca M, Carbognani P, et al. Contralateral spontaneous pneumothorax after single lung transplantation for fibrosis. Acta Biomed Ateneo Parmense 1993; 64:29. 

2. Waller DA, Conacher ID, Dark JH. Videothoracoscopic pleurectomy after contralateral single-lung transplantation. Ann Thorac Surg 1994; 57:1021.