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Published on: August 15, 2022
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Living-donor lobar lung transplantation
Daisuke Nakajima1, Hiroshi Date1
1Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Journal of Thoracic Disease
|January 7, 2022
Summary
Living-donor lobar lung transplantation (LDLLT) offers a vital option for respiratory failure patients, achieving outcomes comparable to deceased donor transplants. Careful donor selection and graft matching ensure good results while minimizing donor risk.
Area of Science:
- Thoracic Surgery
- Transplantation Medicine
- Pulmonology
Background:
- Living-donor lobar lung transplantation (LDLLT) emerged to address organ shortages.
- It provides a life-saving option for patients with severe respiratory disorders.
- LDLLT outcomes are comparable to deceased donor lung transplantation.
Purpose of the Study:
- To evaluate the efficacy and safety of living-donor lobar lung transplantation.
- To highlight the importance of graft size matching in LDLLT.
- To discuss advancements in LDLLT techniques for size mismatch.
Main Methods:
- Preoperative functional and anatomical size matching between donor grafts and recipients.
- Surgical procedures adapted for graft size mismatch (e.g., lobe-sparing, inverted transplantation).
- Monitoring of donor safety and recipient post-transplant outcomes.
Main Results:
- Kyoto University reported 5- and 10-year survival rates of 79.0% and 64.6% post-LDLLT.
- Living donor surgery had a morbidity rate of <15%, with donors returning to normal lives.
- Precise size matching correlated with favorable post-transplant pulmonary function and exercise capacity.
Conclusions:
- LDLLT is a viable and effective treatment for severe respiratory failure.
- Careful donor selection and meticulous graft size matching are crucial for successful LDLLT.
- Ongoing procedural innovations continue to improve LDLLT outcomes, even with size discrepancies.
