Lung Autotransplantation for Treating Primary Pulmonary Artery Sarcoma

J. Chen, J. He, S. Li
the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong

Please explain the educational or technical point that this video addresses.: 1.Right lung autotransplatation was successfully performed to avoid pneumonectomy, which was in line with organ preservation strategies.
2.Using cold low-potassium dextran glucose solution for cold lung preservation protected the lung graft from ischaemia re-perfusion injury and ensured enough time to achieve R0 resection during the ex vivo procedure.

Please provide a 250 word summary of the surgical video being submitted.: Primary pulmonary artery (PA) sarcoma is rare, which originates in the intima of the pulmonary artery. With limited treatment options, surgical resection is considered the cornerstone therapy. In order to achieve complete resection, pneumonectomy is required when PA tumor completely occluded the PA and/or extensively involves the lung. When compared to pneumonectomy, lung autotransplatation not only conserves more lung tissue but also preserves a greater degree of pulmonary function and benefit the quality of life. Hereby, we successfully performed lung autotransplatation for a patient with PA sarcoma.
A 72-year-old man was referred to our hospital with a unilateral occlusive material within the right main PA. Pathology confirmed pulmonary artery sarcoma. After a multidisciplinary team (MDT) discussion, we decided to perform right lung autotransplatation for the patients. The surgical procedure was shown in the Video. The patient’s postoperative course was uneventful. Three months postoperatively, CT scan showed tracheal and pulmonary vascular anastomosis were well. The patient was alive and well without any symptom.
Based on our experience, the utilization of lung autotransplatation for patient with PA sarcoma is feasible and safe. This successful case may indicate that lung autotransplantation is a promising surgical option for selected patients with PA sarcoma, which is in line with organ preservation strategies