Unusual cause of entire lung ventilation-perfusion mismatch

This case demonstrates preferential perfusion with normal bilateral ventilation of a left lung transplanted for idiopathic pulmonary fibrosis. Quantitative ventilation and perfusion imaging was performed using Xe-133 and Tc-99m macroaggregated albumin. Elevated pulmonary vascular resistance of the native diseased lung resulted in increased pulmonary blood flow to the transplanted lung. Ventilation with 100% oxygen did not change the distribution of perfusion.