Contralateral lung transplantation: a left lung implanted in the right thorax

Couëtil, Jean-Paul; Argyriadis, Pantelis G.; Tolan, Michael; Achkar, A.; Carpentier, Alain

doi:10.1016/s0003-4975(01)02394-3

Cited by 13 publications

(8 citation statements)

References 6 publications

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“…In deceased-donor lung transplantation, several surgical modifications have been performed to counter the severe donor shortage worldwide, such as pulmonary bipartitioning, lobar transplantation, and inverted left lung transplantation into the right thorax (12)(13)(14)(15)(16). In LDLLT, native lungsparing bilateral LDLLT and single LDLLT with contralateral lung resection also have been reported (17,18); however, there are no reports of right and left inverted lobar lung transplantation.…”

Section: Discussionmentioning

confidence: 99%

Right and Left Inverted Lobar Lung Transplantation

Chen

Miyamoto

Takemoto

et al. 2015

American Journal of Transplantation

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Adult recipients frequently withdraw from livingdonor lobar lung transplantation because of the small size of donor grafts. The right lower lobe is 120% larger than the left lower lobe. We developed a novel surgical technique in which an inverted right lower lobe graft can be transplanted into the left thorax. The first patient was a 43-year-old woman with end-stage idiopathic interstitial pneumonia. Her husband was the only eligible donor for living-donor lobar lung transplantation. His right lower lobe was estimated to provide 45% of the recipient's predicted forced vital capacity, which would provide the borderline function required for living-donor lobar lung transplantation. Since lung perfusion scintigraphy of the recipient showed a right-to-left ratio of 64:36, transplanting the right lower lobe graft into the left thorax and sparing the native right lung was considered the only treatment option. We simulated this procedure using three-dimensional models produced by a three-dimensional printer. In living-donor lobar lung transplantation, all anastomoses were performed smoothly as planned preoperatively. Because of the initial success, this procedure was performed successfully in two additional patients. This procedure enables larger grafts to be transplanted, potentially solving critical size matching problems in livingdonor lobar lung transplantation.

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Section: Discussionmentioning

confidence: 99%

Right and Left Inverted Lobar Lung Transplantation

Chen

Miyamoto

Takemoto

et al. 2015

American Journal of Transplantation

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“…Inverted lung transplantation provides a greater opportunity for single-lung transplantation in patients with uneven disease laterality. This is the first known report of right-to-left inverted single-lung transplantation, whereas Couetil and colleagues 2 previously reported a left-to-right lung transplant. We have treated 3 patients, including the present patient, with inverted lung transplantation and obtained good results.…”

Section: Discussionmentioning

confidence: 72%

Right-to-left inverted single lung transplantation

et al. 2020

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“…In inverted lung transplantation [1], the graft bronchus is located anteriorly and the graft pulmonary artery and vein are located posteriorly to the recipient's hilar structures. The rigidity of the bronchus usually determines Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The development of flexible surgical procedures has increased the chances of lung transplantation (LTx) by unfolding recipient-to-donor matching options based on the pre-existing organ allocation concept; surgery to liberate the grafting side is one such example. In particular, a single inverted left-to-right LTx may be considered under the following conditions: 1) despite a right-sidepredominant lung dysfunction in the recipient candidate, the available donor organ options are limited to the use of a left single donor lung, based on evidence of right donor lung injury or the need for the donor lung to be shared with another candidate with waitlist priority; or 2) a left side transplantation in the recipient is impossible because of a past history of thoracic surgery [1]. The need to adjust the positional relationships because of the take-off angle mismatch of the hilar structures is one of the key challenges in inverted transplantation.…”

Section: Introductionmentioning

confidence: 99%

Right single lung transplantation using an inverted left donor lung: interposition of pericardial conduit for pulmonary venous anastomosis - a case report

et al. 2020

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Background: Lung transplantation (LTx) is still limited by the shortage of suitable donor lungs. Developing flexible surgical procedures can help to increase the chances of LTx by unfolding recipient-to-donor matching options based on the pre-existing organ allocation concept. We report a case in which a successful left-to-right inverted LTx was completed using the interposition of a pericardial conduit for pulmonary venous anastomosis. Case presentation: A left lung graft was offered to a 59-year-old male who had idiopathic pulmonary fibrosis with predominant damage in the right lung. He had been prescribed bed rest with constant oxygen inhalation through an oxymizer pendant and had been on the waiting list for 20 months. Considering the condition of the patient (LAS 34.3) and the scarcity of domestic organ offers, the patient was highly likely to be incapable of tolerating any additional waiting time for another donor organ if he was unable to accept the presently reported offer of a left lung. Eventually, we decided to transplant the left donor lung into the right thorax of the recipient. Because of the anterior-posterior position gap of the hilar structures, the cuff lengths of the pulmonary veins had to be adjusted. The patient did not develop any anastomotic complications after the transplantation. Conclusions: A left-to-right inverted LTx is technically feasible using an autologous pericardial conduit for pulmonary venous anastomosis in selected cases. This technique provides the potential benefit of resolving challenging situations in which surgeons must deal with a patient's urgency and the logistical limitations of organ allocation.

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Contralateral lung transplantation: a left lung implanted in the right thorax

Cited by 13 publications

References 6 publications

Right and Left Inverted Lobar Lung Transplantation

Right and Left Inverted Lobar Lung Transplantation

Right-to-left inverted single lung transplantation

Right single lung transplantation using an inverted left donor lung: interposition of pericardial conduit for pulmonary venous anastomosis - a case report

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