Atelectasis is a reversible factor in hypoxemia among brain-dead donors. In ineligible donors, prone positioning reverses atelectasis and improves oxygenation. We present a successful lung transplantation after salvaging a previously unviable lung. A 37-year-old woman presented with acute pontine hemorrhage that progressed to brain death. The initial partial pressure of oxygen (PaO₂)/fraction of inspired oxygen (FiO₂) ratio of the donor’s lung was 342 mmHg. The PaO₂/FiO₂ ratio dropped to 49 mmHg due to atelectasis. There was no improvement despite recruitment maneuvers, bronchoscopy, and chest percussion. After placing the donor in the prone position for four hours, electrical impedance tomography showed improved atelectasis. The donor did not experience hemodynamic instability. The lung was transplanted into a patient with Kartagener’s syndrome with situs inversus. The surgical procedure was uneventful. He was successfully weaned from the mechanical ventilator on the second-day post-transplantation and was discharged from the hospital after 4 weeks.

肺不张是脑死亡供体低氧血症的可逆因素。在不符合条件的供体中，俯卧位可逆转肺不张并改善氧合。在挽救了以前无法生存的肺后，我们提出了成功的肺移植。一名 37 岁女性出现急性脑桥出血并进展为脑死亡。供体肺的初始氧分压（PaO ₂）/吸入氧分数（FiO ₂）比为342 mmHg。PaO ₂ /FiO ₂由于肺不张，该比率降至 49 mmHg。尽管进行了肺复张、支气管镜检查和胸部叩诊，但没有改善。将供体置于俯卧位 4 小时后，电阻抗断层扫描显示肺不张有所改善。供体没有出现血流动力学不稳定。肺被移植到患有内翻性卡塔格纳综合征的患者体内。手术过程很顺利。移植后第二天成功脱离机械呼吸机，4周后出院。