Urgent lung transplantation in acute fibrinous and organizing pneumonia: a sliding door or a new perspective?

Background: Lung transplantation is nowadays the standard therapy for certain well-defined chronic end-stage lung diseases, even in patients on mechanical ventilation or extracorporeal life support. While these latter techniques have been used worldwide as bridging options to lung transplantation for listed patients, they are not commonly used in previously healthy patients developing acute not-reversible lung failure. Methods: We will discuss two patients without any relevant medical history developing acute lung failure evolving to irreversible acute fibrinous and organising pneumonia (AFOP), thus listed for urgent lung transplantation. Results: The patients recovered well, and both are still alive. Conclusions: In the absence of clear guidelines, our approach showed, in these patients, the possible benefits of lung transplantation regarding survival in AFOP.