Improved survival after living-donor lobar lung transplantation

Hiroshi Date, Motoi Aoe, Yoshifumi Sano, Itaru Nagahiro, Katsumasa Miyaji, Keiji Goto, Masaaki Kawada, Shunji Sano, Nobuyoshi Shimizu

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Abstract

Survival after living-donor lobar lung transplantation has been reported to be similar to that after cadaveric lung transplantation. The purpose of this study was to summarize our 5-year experience of living-donor lobar lung transplantation for critically ill patients. Between October 1998 and April 2004, we performed living-donor lobar lung transplantation in 30 critically ill patients with various lung diseases, including 5 (17%) patients on a ventilator. Mean age was 30.4 years (range, 8-55 years). Postoperative management included slow weaning from a ventilator, relatively low-dose immunosuppressants, and careful rejection monitoring on the basis of radiographic and clinical findings without transbronchial lung biopsy. The average duration of mechanical ventilation was 15.4 days, intensive care unit stay was 23.5 days, and hospital stay was 64.6 days. Clinically judged acute rejection occurred at an average rate of 1.5 episodes per patient, but infection occurred in only one patient during the first month. In spite of the complicated postoperative course, all patients were discharged without oxygen inhalation. Four patients had unilateral bronchiolitis obliterans syndrome, but the decrease in their forced expiratory volume in 1 second values stopped within 9 months. All 30 recipients are currently alive, with a follow-up period of 1 to 66 months. All donors have returned to their previous lifestyles. Living-donor lobar lung transplantation can be applied to both pediatric and adult patients with very limited life expectancies. It might provide better survival than conventional cadaveric lung transplantation.

Original languageEnglish
Pages (from-to)933-940
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume128
Issue number6
DOIs
Publication statusPublished - Dec 1 2004

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ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Date, H., Aoe, M., Sano, Y., Nagahiro, I., Miyaji, K., Goto, K., Kawada, M., Sano, S., & Shimizu, N. (2004). Improved survival after living-donor lobar lung transplantation. Journal of Thoracic and Cardiovascular Surgery, 128(6), 933-940. https://doi.org/10.1016/j.jtcvs.2004.07.032