Long-term Improvement in Pulmonary Function After Living Donor Lobar Lung Transplantation

Masaomi Yamane, Hiroshi Date, Megumi Okazaki, Shinichi Toyooka, Motoi Aoe, Yoshifumi Sano

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: As an alternative to cadaveric transplantation, living donor lobar lung transplantation (LDLLT) has been applied in critical patients with end-stage pulmonary disease because of the mismatch between the supply and demand of lungs for transplantation. However, it is unclear whether two pulmonary lobes can provide adequate long-term pulmonary function and satisfactory clinical outcome in recipients. Methods: Between October 1998 and September 2004, 28 females and 3 males, including 5 children, underwent LDLLT at Okayama University Hospital. Their mean age was 31.8 years, and the mean observation period was 53.8 months. One patient who underwent single-lung transplantation and another who died peri-operatively were excluded from further analyses. Results: The most common indication for transplantation was pulmonary arterial hypertension (32.3%). The overall survival rate was 93.6%. Seven recipients (22.6%) developed bronchiolitis obliterans syndrome after LDLLT. The mean percent predicted forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) improved between 12 and 24 months after transplantation (71.8 ± 12.9% and 65.8 ± 17.2% at 12 months vs 77.4 ± 16.6% and 72.8 ± 14.6% at 24 months; p <0.005 and p <0.05, respectively). The actual recipient FVC ultimately reached 123.0% of the estimated graft FVC of two donor lobes (calculated based on the donor FVC and number of segments implanted) at 36 months after LDLLT. Conclusions: Although LDLLT may be associated with the limitation of size mismatch, it holds promise for providing well-functioning pulmonary lobar grafts to critically ill patients with poor life expectancy.

Original languageEnglish
Pages (from-to)687-692
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume26
Issue number7
DOIs
Publication statusPublished - Jul 2007

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Lung Transplantation
Living Donors
Vital Capacity
Lung
Transplantation
Tissue Donors
Bronchiolitis Obliterans
Transplants
Forced Expiratory Volume
Life Expectancy
Pulmonary Hypertension
Critical Illness
Lung Diseases
Survival Rate
Observation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Long-term Improvement in Pulmonary Function After Living Donor Lobar Lung Transplantation. / Yamane, Masaomi; Date, Hiroshi; Okazaki, Megumi; Toyooka, Shinichi; Aoe, Motoi; Sano, Yoshifumi.

In: Journal of Heart and Lung Transplantation, Vol. 26, No. 7, 07.2007, p. 687-692.

Research output: Contribution to journalArticle

Yamane, Masaomi ; Date, Hiroshi ; Okazaki, Megumi ; Toyooka, Shinichi ; Aoe, Motoi ; Sano, Yoshifumi. / Long-term Improvement in Pulmonary Function After Living Donor Lobar Lung Transplantation. In: Journal of Heart and Lung Transplantation. 2007 ; Vol. 26, No. 7. pp. 687-692.
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abstract = "Background: As an alternative to cadaveric transplantation, living donor lobar lung transplantation (LDLLT) has been applied in critical patients with end-stage pulmonary disease because of the mismatch between the supply and demand of lungs for transplantation. However, it is unclear whether two pulmonary lobes can provide adequate long-term pulmonary function and satisfactory clinical outcome in recipients. Methods: Between October 1998 and September 2004, 28 females and 3 males, including 5 children, underwent LDLLT at Okayama University Hospital. Their mean age was 31.8 years, and the mean observation period was 53.8 months. One patient who underwent single-lung transplantation and another who died peri-operatively were excluded from further analyses. Results: The most common indication for transplantation was pulmonary arterial hypertension (32.3{\%}). The overall survival rate was 93.6{\%}. Seven recipients (22.6{\%}) developed bronchiolitis obliterans syndrome after LDLLT. The mean percent predicted forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) improved between 12 and 24 months after transplantation (71.8 ± 12.9{\%} and 65.8 ± 17.2{\%} at 12 months vs 77.4 ± 16.6{\%} and 72.8 ± 14.6{\%} at 24 months; p <0.005 and p <0.05, respectively). The actual recipient FVC ultimately reached 123.0{\%} of the estimated graft FVC of two donor lobes (calculated based on the donor FVC and number of segments implanted) at 36 months after LDLLT. Conclusions: Although LDLLT may be associated with the limitation of size mismatch, it holds promise for providing well-functioning pulmonary lobar grafts to critically ill patients with poor life expectancy.",
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