Postoperative pulmonary function and complications in living-donor lobectomy

Area of Science:

• Thoracic Surgery
• Transplantation Medicine
• Surgical Outcomes

Background:

• Living-donor lobar lung transplantation success relies on donor safety.
• Surgical techniques and peri-operative care have advanced, necessitating updated outcome evaluations.

Purpose of the Study:

• To evaluate recent outcomes of donor lobectomies in living-donor lobar lung transplantation.
• To assess donor morbidity and mortality following lobectomy.

Main Methods:

• Retrospective analysis of 85 donor lobectomies from 48 consecutive living-donor lobar lung transplantations (2008-2014).
• Prospective follow-up of all donors for 1 year post-surgery.
• Detailed recording of intraoperative and post-operative complications.

Main Results:

• No donor mortality occurred; all donors were discharged post-lobectomy.
• Overall post-operative complication rate was 28% (24/85 donors), with pneumothorax, pleuritis, and pleural effusion being most common.
• Pulmonary function recovered better than expected, unaffected by pulmonary artery branch sacrifice; however, complications were associated with lower 1-year function.

Conclusions:

• Living-donor lobectomies are safe procedures with low morbidity and no mortality in the recent era.
• Donor outcomes are generally favorable, with good pulmonary function recovery.
• Careful peri-operative management is crucial for optimizing donor outcomes and minimizing long-term pulmonary function deficits.