Bilateral lung transplantation in severe chest asymmetry: case series from a single center

Suppurative lung diseases leading to end-stage respiratory failure are typical indications for bilateral lung transplantation. Some cases may present severe chest asymmetry because of recurrent infections or previous surgical therapies, especially in patients with cystic  brosis. To deal with this anatomical condition, the most used surgical options are single lung transplantation with contralateral pneumonectomy or bilateral transplantation with graft downsizing. The purpose of this study is to evaluate the treatment we practiced at our institution for this subset of patients and review surgical strategies and technical aspects reported by others.