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Living-donor lobar lung transplantation experience: intermediate results
V A Starnes1, M L Barr, R G Cohen
1Division of Cardiothoracic Surgery, University of Southern California School of Medicine, Los Angeles 90033-4612, USA.
The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1996
Summary
Living-donor lobar lung transplantation provides a viable option for critically ill patients. Intermediate results show encouraging survival and functional outcomes, supporting its expanded use.
Area of Science:
- Cardiothoracic Surgery
- Transplantation Medicine
- Pulmonary Medicine
Background:
- Living-donor lobar lung transplantation (LDLLT) is an alternative for patients with limited life expectancy.
- This study evaluates intermediate outcomes of LDLLT.
Purpose of the Study:
- To assess recipient survival, complications, pulmonary function, and hemodynamic reserve after LDLLT.
- To determine the feasibility and efficacy of LDLLT in a critically ill population.
Main Methods:
- Thirty-eight LDLLT procedures were performed in 37 patients (27 adult, 10 pediatric) for various conditions, primarily cystic fibrosis.
- Seventy-six donors underwent lobectomies; donor and recipient outcomes were monitored.
Main Results:
- 14 deaths occurred among 37 patients within a 14-month average follow-up, with infection as the primary cause.
- Postoperative pulmonary function improved steadily, and hemodynamic reserve remained within normal ranges.
- Three patients developed bronchiolitis obliterans; donor complications were generally minor.
Conclusions:
- LDLLT demonstrates encouraging intermediate outcomes regarding survival and functional recovery.
- These findings support an expanded role for LDLLT in managing end-stage lung disease.