Work

Perioperative management of transforaminal lumbar interbody fusion in a post-double lung transplant recipient: A case report

Year: 2025

Type: article

Abstract: Background: As long-term survival following lung transplantation improves, anesthesiologists increasingly encounter such patients for elective non-transplant surgeries. These patients present unique perioperative challenges due to altered pulmonary physiology, chronic immunosuppression, and multiple comorbidities.Case Presentation: We report the case of a 56-year-old female with a history of double lung transplantation in 2022, who presented with severe lumbar spinal canal stenosis and underwent elective L4-L5 transforaminal lumbar interbody fusion (TLIF) with L3-L4 decompression. Her comorbidities included well-controlled hypertension, type 2 diabetes mellitus, hypothyroidism post-total thyroidectomy, and she was on maintenance immunosuppressive therapy. Preoperative investigations revealed a restrictive pulmonary pattern, cardiomegaly with a dilated main pulmonary artery, mosaic attenuation in both lungs, and an ejection fraction of 70% with mild left atrial enlargement. She was evaluated and deemed fit for surgery by a multidisciplinary team including a chest physician, cardiologist, and nephrologist. The procedure was successfully performed under general anesthesia with lung-protective ventilation and strict aseptic precautions. Her postoperative course was uneventful, and she was discharged on postoperative day six.Conclusion: This case underscores the importance of individualized perioperative management, vigilant respiratory and infection control strategies, and multidisciplinary coordination in ensuring favorable outcomes for lung transplant recipients undergoing elective spine surgery.

Source: International Journal of Medical Anesthesiology

DOI: 10.33545/26643766.2025.v8.i4a.591

Authors: Abdul Vahid, Senthil Nath M

Institution: Apollo Hospitals

Language: English

Topic: Cardiac, Anesthesia and Surgical Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4414966417