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Lobar transplantation, split lung transplantation and peripheral segmental resection--reliable procedures for
Clemens Aigner1, Samy Mazhar, Peter Jaksch
1Department of Cardiothoracic Surgery, Vienna University, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
Summary
Lung transplantations can be downsized for smaller recipients using techniques like split or lobar transplantation. This size-reduced lung transplantation offers comparable outcomes to standard procedures, addressing donor lung scarcity.
Area of Science:
- Thoracic Surgery
- Transplantation Medicine
- Pediatric Surgery
Background:
- Donor lung scarcity limits transplantation, particularly for pediatric recipients.
- Novel techniques are emerging to resize donor lungs for smaller recipients.
- Size reduction in lung transplantation is not yet a standard procedure.
Purpose of the Study:
- To evaluate the safety and efficacy of size-reduced lung transplantation techniques.
- To compare outcomes of size-reduced lung transplants with standard lung transplants.
- To analyze peri-operative complications and survival rates.
Main Methods:
- Retrospective analysis of 98 primary lung transplantations (2001-2002).
- Comparison of 27 size-reduced transplants (lobar, split, segmental resection) with standard transplants.
- Analysis of bronchial healing, bleeding, and survival rates.
Main Results:
- 27.6% of transplants were size-reduced.
- No significant differences in bronchial healing or bleeding rates between groups.
- Three-month survival: 85.2% for size-reduced vs. 92.9% for standard (P=0.13).
Conclusions:
- Size-reduced lung transplantation is a reliable procedure.
- Techniques include split lung, lobar transplantation, and peripheral segmental resection.
- Results are comparable to standard lung transplantation.