Donor selection for single and double lung transplantation. Chest size matching and other factors influencing posttransplantation vital capacity

In six single lung transplant (SLT) and six double lung transplant (DLT) recipients, the relationships of the recipient's posttransplantation vital capacity (posttx VC(R)) to the recipient's predicted normal vital capacity (pred VC(R)) and the donor's predicted normal vital capacity (pred VC(D)) were investigated. After left SLT the left posttx VC(R) was correlated with the left predicted VC(D) (r = 0.83; p < 0.05); however, no correlation was found between these after DLT. In contrast, there was a tendency toward correlation between the posttx VC(R) and the predicted VC(R9 after DLT (r = 0.75; p < 0.01), but no such trend was apparent after SLT. These results suggest that posttx VC(R) depends primarily on predicted VC(D) after SLT and on pred VC(R) after DLT. Therefore, in donor-recipient size matching for lung transplantation, a donor with a pred VC(D) greater than the pred VC(R) should be chosen for a left SLT recipient, whereas a donor with a pred VC(D) near the pred VC(R) would be suitable for a DLT recipient.