Refractory chylothorax after lung transplantation for lymphangioleiomyomatosis successfully cured with instillation of povidone

Successful management of bilateral refractory chylothorax after double lung transplantation for lymphangioleiomyomatosis

Lymphangioleiomyomatosis (LAM) is a rare disease that leads to airways and lymphatic channels obstruction due to abnormal smooth muscle proliferation. It presents with dyspnea, pneumothorax or chylothorax. Lung transplantation (LT) has emerged as a valuable therapeutic option with limited reports. We report a case of LAM that underwent double LT and complicated by refractory bilateral chylothorax which was managed successfully by povidone-iodine pleurodesis and the addition of sirolimus to the post-transplantation immunosuppressive therapy. The patient has no recurrence with 24 months follow-up.

Chylopericardium following orthotopic lung transplantation

Chylopericardium is an uncommon condition, reported to occur following routine cardiac surgery, orthotopic heart transplantation, cardiac trauma, intrathoracic tumors, or infection. It has not, to date, been reported following uncomplicated orthotopic lung transplantation. This article describes chylopericardium following bilateral orthotopic lung transplantation.

Successful factor XIII administration for persistent chylothorax after lung transplantation for lymphangioleiomyomatosis

Lung transplantation has emerged as a viable treatment option for patients with end-stage lymphangioleiomyomatosis (LAM), and therapeutic outcome results reported thus far have been satisfactory. However, persisting chylothorax after transplantation for LAM remains a challenging problem, and the optimal management has not been decided. We present the case with persistent chylothorax after lung transplantation for LAM, in which the intravenous administration of a tissue repair factor (human factor XIII) resulted in complete resolution of chylous effusion without performing additional invasive treatments, leading to a successful transplant outcome.

Persistent chylothorax in lymphangioleiomyomatosis treated by intrapleural instillation of povidone

Lymphangioleiomyomatosis (LAM) is a rare, idiopathic disease affecting young women often complicated by refractory and difficult to manage chylothorax. We report one case of a patient who received a bilateral lung transplantation for LAM presenting a refractory chylothorax. The instillation of povidone iodine in the pleural space was effective in inducing pleurodesis.