A rare indication for lung transplantation - pulmonary alveolar microlithiasis: institutional experience of five consecutive cases

Clin Transplant. 2016 Apr;30(4):429-34. doi: 10.1111/ctr.12705. Epub 2016 Feb 24.

Abstract

Background: Pulmonary alveolar microlithiasis (PAM) is a rare lung disease caused by calcifications within the alveolar space. The only known effective treatment for an end-stage PAM is lung transplantation (LuTX).

Methods: We performed a retrospective chart review of all individuals that underwent lung transplantation at our center between 1989 and 2013. Five consecutive patients with PAM were identified.

Results: Four females and one male with a mean age of 46.3 yr were identified. Extracorporeal membrane oxygenation (ECMO) support was required intraoperatively in four cases and post-operatively in one case. Mean post-operative intubation time was 3.3 (range, 2-5) d and mean intensive care unit (ICU) stay was 8.3 (range, 4-12) d. No intraoperative complications were observed. One early patient (operated in 1995) underwent acute re-transplantation on the second post-operative day (POD) and died from sepsis on the 11 POD. In one patient reperfusion edema was observed requiring a prolonged weaning process. No other severe perioperative complications were observed. Four of five patients are currently still alive with normal follow-up parameters. No recurrence of PAM was observed.

Conclusions: Lung transplantation is a feasible therapy option in patients with end-stage PAM showing good post-operative results comparable to other indications for LuTX.

Keywords: extracorporeal membrane oxygenation; lung transplantation; outcome; pulmonary alveolar microlithiasis.

MeSH terms

  • Adolescent
  • Adult
  • Calcinosis / surgery*
  • Extracorporeal Membrane Oxygenation
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Genetic Diseases, Inborn / surgery*
  • Graft Survival
  • Humans
  • Lung Diseases / surgery*
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Young Adult

Supplementary concepts

  • Pulmonary Alveolar Microlithiasis