Thoracic transplanationOutcomesSize-reduced lung transplantation: An advanced operative strategy to alleviate donor organ shortage
Section snippets
Patients and methods
This report retrospectively reviews our experience from January 2001 to December 2003 with cadaveric size-reduced lung transplantation, including split-lung transplantation, lobar transplantation, and downsizing by means of peripheral wedge resections, with regard to waiting time implications, perioperative complications, and outcomes.
One hundred sixty three patients underwent primary lung transplantation at our institution during the observation period. Size-reduced lung transplantation was
Results
Within the observation period 51 (31.3%) of 163 primary lung transplantations were size-reduced. Size reduction was achieved by lobar transplantation (n = 18), split-lung transplantation (n = 2), or peripheral segmental resection (n = 31). As one might expect the patients receiving size-reduced organs were significantly younger (39.56 ± 15.65 vs 48.65 ± 14.82 years; P < .001) and the underlying diagnoses different from those receiving standard lung transplants (Fig 1). Two patients in the
Discussion
Donor organ scarcity is one of the major limitations in lung transplantation today. Various methods are used to exploit available donor organs and if possible increase the donor pool. Especially for small adult and pediatric recipients, downsizing of donor lungs may considerably increase the donor pool, since it allows the use of larger donor organs for these patients. Downsizing can also be applied and increase the available donor organs if a localized pathology is found in one donor lobe.
References (8)
- et al.
Downsizing of the donor lung: peripheral segmental resections and lobar transplantation
Transplant Proc
(1997) - et al.
Pulmonary bipartitioning and lobar transplantation: a new approach to donor organ shortage
J Thorac Cardiovasc Surg
(1997) - et al.
Bilateral lobar transplantation with the split lung technique
J Thorac Cardiovasc Surg
(1999) - et al.
Living-related donor lobectomy for bilateral lobar transplantation in patients with cystic fibrosis
Ann Thorac Surg
(1994)