Improved survival after living-donor lobar lung transplantation

Date, Hiroshi; Aoe, Motoi; Sano, Yoshifumi; Nagahiro, Itaru; Miyaji, Kagami; Goto, Keiji; Kawada, Manabu; Sano, Shunji; Shimizu, Nobuyoshi

doi:10.1016/j.jtcvs.2004.07.032

Cited by 77 publications

(39 citation statements)

References 17 publications

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“…In this situation, the right lower lobe is removed from one donor and transplanted into the right chest, and the left lower lobe is removed from another donor and transplanted into the left chest. Date and colleagues in Japan have a large experience with this technique and have shown excellent outcomes (Date et al 2004). Experience in the United States with this technique has waned since the introduction of the LAS allocation system.…”

Section: Lung Transplant Proceduresmentioning

confidence: 99%

Overview of Clinical Lung Transplantation

Yeung

Keshavjee

2014

Cold Spring Harbor Perspectives in Medicine

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Since the first successful lung transplant 30 years ago, lung transplantation has rapidly become an established standard of care to treat end-stage lung disease in selected patients. Advances in lung preservation, surgical technique, and immunosuppression regimens have resulted in the routine performance of lung transplantation around the world for an increasing number of patients, with wider indications. Despite this, donor shortages and chronic lung allograft dysfunction continue to prevent lung transplantation from reaching its full potential. With research into the underlying mechanisms of acute and chronic lung graft dysfunction and advances in personalized diagnostic and therapeutic approaches to both the donor lung and the lung transplant recipient, there is increasing confidence that we will improve short-and long-term outcomes in the near future.

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Section: Lung Transplant Proceduresmentioning

confidence: 99%

Overview of Clinical Lung Transplantation

Yeung

Keshavjee

2014

Cold Spring Harbor Perspectives in Medicine

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“…This procedure has been used widely with good results because of a critical deficit in deceased-donor organs, particularly in Japan (3)(4)(5). Approximately 350 lung transplants have been performed in Japan since 1998, and almost 40% of these were LDLLT (6).…”

Section: Introductionmentioning

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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“…Na série de Date et al, incluindo 30 pacientes, a sobrevida hospitalar foi de 100%, com todos os pacientes vivos no momento da publicação 7 . Deve-se destacar que essa casuística é excepcional, em virtude de peculiaridades da população japonesa, com incidência baixa de fibrose cística e tendo hipertensão arterial pulmonar e fibrose intersticial como as principais indicações de transplante.…”

Section: Discussionunclassified

Twelve-year survival of the first living-donor pediatric lung transplantation in Brazil

Machuca¹,

Filho²,

Schio³

et al. 2012

J Pediatr (Rio J)

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Objective: To report the long-term follow-up of the first living-donor lobar lung transplantation performed in Latin America. Description:The patient was a 12-year-old boy with post-infectious obliterative bronchiolitis with end-stage pulmonary disease. He was on continuous oxygen support, presenting with dyspnea even during minimal activity. He underwent bilateral lobar lung transplantation with living donors. The procedure was performed with the left and right lower lobes of two different related donors. In the second side cardiopulmonary bypass was required. The transplant was uneventful, and the patient was extubated after 14 hours and discharged with 44 days, after resolution of infectious, immunological and drug-related complications. After 12 years of follow-up, he presents with adequate lung function and has resumed his habitual activities.Comments: Living-donor lobar lung transplantation is a complex procedure feasible for the treatment of selected pediatric end-stage pulmonary disease. This particular population might benefit from this approach since the availability of pediatric donors is very scarce and the clinical course of pediatric advanced pulmonary disease may be unpredictable.J Pediatr (Rio J). 2012;88(5):413-6: Lung transplantation, bronchiolitis obliterans, living donors, pediatrics. ResumoObjetivo: Apresentar o acompanhamento a longo prazo do primeiro caso de transplante pulmonar intervivos realizado na América Latina.Descrição: Paciente do sexo masculino, com 12 anos de idade, portador de bronquiolite obliterante com doença pulmonar avançada. Fazia uso de oxigênio domiciliar contínuo, com dispneia aos mínimos esforços. Foi submetido a transplante pulmonar bilateral com doadores vivos. A cirurgia foi realizada utilizando os lobos inferiores esquerdo e direito de dois doadores diferentes e com grau de parentesco com o receptor. No segundo lado (direito), foi necessário emprego de circulação extracorpórea. O transplante não teve intercorrências, e o paciente foi extubado com 14 horas de pós-operatório; com 44 dias, recebeu alta hospitalar, após a resolução de complicações infecciosas, imunológicas e medicamentosas. Após 12 anos de seguimento, encontra-se com função pulmonar preservada e desempenha normalmente suas atividades.Comentários: O transplante pulmonar intervivos é um procedimento de alta complexidade que pode contribuir para o tratamento de algumas pneumopatias na infância. Essa população se beneficia dessa abordagem, uma vez que a disponibilidade de doadores pediátricos é muito rara, e as pneumopatias pediátricas tendem a seguir um curso imprevisível. J Pediatr (Rio J)

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Improved survival after living-donor lobar lung transplantation

Abstract: Living-donor lobar lung transplantation can be applied to both pediatric and adult patients with very limited life expectancies. It might provide better survival than conventional cadaveric lung transplantation.

Cited by 77 publications

References 17 publications

Overview of Clinical Lung Transplantation

Overview of Clinical Lung Transplantation

Right and Left Inverted Lobar Lung Transplantation

Twelve-year survival of the first living-donor pediatric lung transplantation in Brazil

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