BACKGROUND Lung transplantation (LTx) is still limited by the shortage of suitable donor lungs. Developing flexible surgical procedures can help to increase the chances of LTx by unfolding recipient-to-donor matching options based on the pre-existing organ allocation concept. We report a case in which a successful left-to-right inverted LTx was completed using the interposition of a pericardial conduit for pulmonary venous anastomosis. CASE PRESENTATION A left lung graft was offered to a 59-year-old male who had idiopathic pulmonary fibrosis with predominant damage in the right lung. He had been prescribed bed rest with constant oxygen inhalation through an oxymizer pendant and had been on the waiting list for 20 months. Considering the condition of the patient (LAS 34.3) and the scarcity of domestic organ offers, the patient was highly likely to be incapable of tolerating any additional waiting time for another donor organ if he was unable to accept the presently reported offer of a left lung. Eventually, we decided to transplant the left donor lung into the right thorax of the recipient. Because of the anterior-posterior position gap of the hilar structures, the cuff lengths of the pulmonary veins had to be adjusted. The patient did not develop any anastomotic complications after the transplantation. CONCLUSIONS A left-to-right inverted LTx is technically feasible using an autologous pericardial conduit for pulmonary venous anastomosis in selected cases. This technique provides the potential benefit of resolving challenging situations in which surgeons must deal with a patient's urgency and the logistical limitations of organ allocation.

中文翻译：

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使用倒置的左供体肺进行右单肺移植：插入心包导管治疗肺静脉吻合-病例报告。

背景技术肺移植（LTx）仍然受到合适的供体肺的短缺的限制。开发灵活的手术程序，可以根据现有的器官分配概念，通过展开受体与受体的匹配选择，来帮助增加LTx的机会。我们报告了一个案例，其中成功地使用心包导管插入肺静脉吻合术成功完成了从左向右倒置的LTx。病例介绍一名59岁男性患有特发性肺纤维化且右肺主要受损的患者接受了左肺移植。他被处方通过卧式呼吸器吊床长期卧床休息，并已在等候名单上待了20个月。考虑到患者的状况（LAS 34.3）和家养器官的短缺，如果患者不能接受目前报道的左肺提议，则该患者极有可能无法忍受任何其他器官等待时间。最终，我们决定将左供体肺移植到受体的右胸中。由于肺门结构的前后位置间隙，必须调整肺静脉的袖带长度。移植后患者未发生任何吻合并发症。结论在某些情况下，使用自体心包导管从左向右倒置LTx在肺静脉吻合中是可行的。该技术提供了解决棘手的情况的潜在好处，在这些情况下，外科医生必须应对患者的紧急性和器官分配的后勤限制。