Atypical single right lung transplantation incorporating rotated left upper lobe and ipsilateral right middle-lower lobes

Single lung transplantation (SLT) remains the procedure of choice for select patients because of the critical donor shortage and possibility of using a marginal donor lung affected by unilateral pneumonia. Couetil and colleagues1 reported a case of separated lung transplantation using left upper lobe (LUL) rotation. However, there are few reports of such a technique for cadaveric lung transplantation.2-4 We previously reported cases with rotated right-to-left and left-to-right SLT.2,3 Here, details regarding techniques for atypical merged right SLT incorporating a rotated LUL and ipsilateral right middle and lower lobes (RMLL) are presented.