Reconstructive Plastic Surgery in a Single Lung Transplant Recipient: A Review of Perioperative Considerations

Background: The number of solid organ transplants as well as long term survival is increasing due to advancements in immunosuppression and technology. In 2016, there were 2,327 lung transplants performed in the United States. With the increase in solid organ transplant recipients (SOTRs), it has become more common to perform plastic and reconstructive surgery procedures on this unique population. Postoperative complications due to the complexity of these patients, especially for lung transplant recipients (LTRs), have not been well characterized. Design: We report an elderly patient with multiple comorbidities, including single lung transplantation with contralateral pneumonectomy, who underwent multi-stage nasal tip reconstruction after mohs surgery for squamous cell carcinoma. We review the perioperative considerations and suggested guidelines for reconstructive surgery in immunocompromised lung transplant recipients, including a multidisciplinary conversation regarding cardiopulmonary clearance, management of immunosuppressive therapy, and careful postoperative observation and follow up.