Lung Transplant Success in Severe Diquat Poisoning: A Case Report

BACKGROUND Diquat is a commonly used herbicide in China, which has the potential to induce severe or fatal poisoning in humans. Diquat is extremely lethal to humans and there is no antidote available. CASE REPORT We report the case of a 26-year-old woman who experienced nausea, vomiting, coughing, and general fatigue after ingesting 80 mL of 20% diquat. Due to the toxic effects of diquat, the patient's condition progressed rapidly, resulting in sequential impairments of liver and kidney function, as well as the development of pulmonary fibrosis. Prior to the surgical procedure, she was supported by extracorporeal membrane oxygenation (ECMO) to manage the preoperative dyspnea. On the 28th day, she a double-lung transplant. On the 8th postoperative day, she was diagnosed with a pulmonary embolism and subsequently accepted right upper-lobe resection surgery. On the 175th postoperative day, she patient was diagnosed with airway stenosis and then underwent tracheal covered stent implantation. Following the lung transplantation, she participated in an active rehabilitation program, complied with the prescribed anti-rejection medication regimen, attended regular follow-up appointments, and had a favorable prognosis. CONCLUSIONS Lung transplantation is currently the most effective treatment for pulmonary fibrosis, and ECMO serves as a temporary support mechanism for patients who have experienced severe diquat poisoning and are awaiting lung transplantation. The complex perioperative complications of the diquat itself can be successfully managed by a multidisciplinary team. The clinicians should be aware of the risk of pulmonary embolism after lung transplantation.