How Do Surgeons Perform Lung Transplants on Patients with Reversed Organs?

[berkeman]

I knew a person back in my undergrad days who had this reversed thoracic organ syndrome. She was initially misdiagnosed for her appendicitis, but luckily had an x-ray to figure out what was going on (and a subsequent successful appendectomy).

It's pretty amazing what these surgeons had to do to adapt normal lungs to the reversed thoracic anatomy of these two patients.

Years ago, people may have lived without realizing their organs were backward. Today, however, most people find out about the condition during a routine medical exam, Bharat said.

“Someone has tried to listen to their heart, and then they don’t find the heartbeat on the left side, so they get an X-ray, and everything looks reversed,” he said.

...

Complicated surgery​

Like Deer, Vega was put on the lung transplant waiting list, and like Deer, needed individualized treatment. Performing an organ transplant on patients with situs inversus is an extraordinary surgical challenge, Bharat said.

“We have to replace the old lungs — which are reversed in the body — with new lungs from a donor who has a typical or normal placement,” he said. “Because the new lungs need to fit into a chest cavity that’s a mirror image, we have to make technical modifications in order to do the surgery.”

Just reattaching blood vessels created in utero for a left lung to openings on a “normal” right lung, for example, was especially difficult. In addition, Deer’s and Vega’s lungs were unique in how their backward organs had developed and grown new blood vessels to compensate for the reversal.

“All these alterations in the anatomy require very careful planning. We had to use specialized 3D scans, mold the new lung to fit into the chest cavity, and then figure out how to tailor vessels and structures to fit in the lung that’s on the normal side,” Bharat said.

“It’s like taking a left sleeve off a shirt and then figuring out how to reattach it to the right side of the shirt instead.”

https://www.cnn.com/2023/08/07/health/reversed-organs-transplant-wellness/index.html

 

[BillTre]

There are zebrafish mutants that have this effect.

 

[berkeman]

There are zebrafish mutants that have this effect.

Interesting. Do you know if it happens at about the same rate, ~1/10,000?

 

[BillTre]

The mutant frequency in research animals is determined by the genetics involved in breeding them and how new mutations were created in labs. So this kind of comparison is not that apt.

Its rare for studies of frequency of mutations in wild zebrafish populations.
Many of the "wild type" (meaning un-mutagenized) zebrafish genetic lines were initiated from fish from fish farms in Florida (which at the time supplied the US commercial pet fish business). These are a selected population from wild fish that might have been imported in the 1930-1950's. They would be selected for the fish farm conditions (which favor certain traits). Probably a genetically less diverse derivative population, that has changed some what. I did find a mutation (floating head) in a population of these fish, which turned out to be found by several other people on different continents because the the pet trade fish were passed around over the years.
I imported fish from India to start a new line. Even these would only be a small sample (~200 fish) of a population from a local area.
These lines were very distinct from the established lab lines in their sex-determination genetics.

Thanks for the opportunity to go on about this genetics stuff.