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Pediatric lobar lung transplantation

T J Watson1, V A Starnes

  • 1Department of Surgery, University of Southern California School of Medicine, Los Angeles, USA.

Seminars in Thoracic and Cardiovascular Surgery
|July 1, 1996
PubMed
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Lung transplant surgeons increasingly use marginal donors and lobe transplantation, especially for children. Living-donor lung transplantation offers similar outcomes to cadaveric transplants, involving two donors for one recipient.

Area of Science:

  • Thoracic Surgery
  • Transplantation Medicine
  • Pediatric Surgery

Background:

  • Shortage of donor lungs necessitates innovative approaches in lung transplantation.
  • Use of marginal donors and lung lobe transplantation is becoming more common.
  • Pediatric lung transplantation often requires specialized techniques due to size discrepancies.

Purpose of the Study:

  • To describe the experience with lobar lung transplantation, including living-donor procedures.
  • To detail the evaluation, surgical techniques, and outcomes for living-donor lung transplantation.
  • To highlight the suitability of specific lung lobes for transplantation in pediatric recipients.

Main Methods:

  • Utilizing marginal donor lungs and downsizing techniques.
  • Performing single or bilateral lobar lung transplantation, particularly the left lower lobe.

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  • Implementing a rigorous evaluation process for living donors and recipients.
  • Describing the technical aspects of donor and recipient surgeries.

    • Main Results:

    • Lobar transplantation, especially from the left lower lobe, is anatomically well-suited.
    • Living-donor lung transplantation has demonstrated early results comparable to cadaveric transplants.
    • Pediatric patients, particularly those with cystic fibrosis, benefit from bilateral lobar transplantation.

    Conclusions:

    • Lobar lung transplantation is a viable option to address donor organ scarcity.
    • Living-donor lung transplantation is a safe and effective alternative for selected patients.
    • Careful patient selection and surgical technique are crucial for successful outcomes in lobar and living-donor lung transplantation.