Lobar Lung Transplantation From Deceased Donors: A Valid Option for Small-Sized Patients With Cystic Fibrosis

Stanzi, Alessia; Decaluwé, Herbert; Coosemans, Willy; Leyn, Paul De; Nafteux, Philippe; Veer, Hans Van; Dupont, Lieven; Verleden, Geert M.; Raemdonck, Dirk Van

doi:10.1016/j.transproceed.2014.09.168

Cited by 23 publications

(20 citation statements)

References 17 publications

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“…Of these, 32 abstracts and 18 full-text publications were assessed (Figure 2 ). Nine studies fulfilled our inclusion criteria for final review[ 6 , 7 , 10 - 16 ] (Table 1 ). Reviewer agreement on selection of abstracts was 100% (K = 1.0) and on inclusion of articles for the final review it was 100% (K = 1.0).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported pTLCdonor Full , pTLCdonor Lobar and pLTCrecipient[ 6 , 11 ]. Data to calculate these parameters were provided for five additional studies[ 7 , 12 , 13 , 15 , 16 ] and pTLCdonor Full , pTLCdonor Lobar and pLTCrecipient was then available for 242 of 301 donor-recipient pairs of ddLLTx (Figure 1 ). The mean pTLCdonor Full was 6.42 ± 1.0 L and after lobar resections was reduced to pTLCdonor Lobar 3.83 ± 0.8 L. The mean pLTCrecipient was 5.27 ± 1.0 L. The mean pTLCratio Full was 1.25 ± 0.3 and was reduced to a mean pTLCratio Lobar 0.76 ± 0.2.…”

Section: Resultsmentioning

confidence: 99%

“…ddLLTx was first described by Bisson et al[ 8 ] in 1994. Subsequently, several single center reports on ddLLTx have been published[ 6 , 7 , 9 - 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Lobar lung transplantation from deceased donors: A systematic review

Eberlein¹,

Reed²,

Chahla³

et al. 2017

WJT

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AIMTo systematically review reports on deceased-donor-lobar lung transplantation (ddLLTx) and uniformly describe size matching using the donor-to-recipient predicted-total lung-capacity (pTLC) ratio.METHODSWe set out to systematically review reports on ddLLTx and uniformly describe size matching using the donor-to-recipient pTLC ratio and to summarize reported one-year survival data of ddLLTx and conventional-LTx. We searched in PubMed, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley (CDSR), Database of Abstracts of Reviews of Effects via Wiley (DARE), Cochrane Central Register of Controlled Trials via Wiley (CENTRAL), Scopus (which includes EMBASE abstracts), and Web of Science for original reports on ddLLTx.RESULTSNine observational cohort studies reporting on 301 ddLLTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The ddLLTx-group was often characterized by high acuity; however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pTLC ratio was available for 242 ddLLTx (80%). The mean pTLCratio before lobar resection was 1.25 ± 0.3 and the transplanted pTLCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddLLTx-group ranged from 50%-100%, compared to 72%-88% in the conventional-LTx group. In the largest study ddLLTx (n = 138) was associated with a lower one-year-survival compared to conventional-LTx (n = 539) (65.1% vs 84.1%, P < 0.001).CONCLUSIONFurther investigations of optimal donor-to-recipient size matching parameters for ddLLTx could improve outcomes of this important surgical option.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Lobar lung transplantation from deceased donors: A systematic review

Eberlein¹,

Reed²,

Chahla³

et al. 2017

WJT

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“…A number of strategies to expand the donor pool have been used in the current era of donor organ scarcity [ 7 – 10 ]. There are several conditions that may lead to the indication for a lobar lung transplant, such as small-sized patients with cystic fibrosis [ 11 ], other pediatric and small adult recipients [ 12 ], and patients just challenged by clinical course deterioration who cannot wait for a suitable donor size-match [ 13 ]. Recent evidence suggests that this type of transplantation is safe and feasible, as both short- and long-term outcomes are, in general, comparable with those of standard bilateral lung transplantation [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Moving Back to the Future: Use of Organ Care System Lung for Lobectomy Before Lobar Lung Transplantation

Sabashnikov

Zeriouh

Mohite

et al. 2016

Med Sci Monit Basic Res

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BackgroundLung transplantation remains the gold standard treatment for patients with end-stage lung disease. Lobar lung transplantation allows for transplantation of size-mismatch donor lungs in small recipients; however, donor lung volume reduction represents a challenging surgical technique. In this paper we present our initial experience with bilateral lobectomy in donor lungs before lobar lung transplantation using normothermic perfusion on the Organ Care System (OCS) Lung.Material/MethodsSpecifics of the surgical technique for donor lung instrumentation on the OCS, lobar dissection on the OCS, and right and left donor lobectomies are presented in detail.ResultsPotential advantages of the use of the OCS for lobectomy for lobar lung transplantation are described in this section. Donor lung volume reduction utilizing OCS appeared to be easier and safer compared to the conventional cold storage technique, due to continuous perfusion of the lungs with blood and well-distended vessels that offer the feel of live lobectomy. Moreover, the OCS represents a platform for donor organ assessment and optimization of its function before transplantation.ConclusionsDonor lung volume reduction was safe and feasible utilizing the OCS, which could be a useful tool for volume reduction in cases of size mismatch. Further research is needed to evaluate early and long-term results after lobar lung transplantation using the OCS in clinical studies.

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“…While size reduction by peripheral segmental resection is widely performed, cadaveric lobar transplantation and split‐lung transplantation are still not considered to be standard procedures . Encouraging results have been published in adult downsized lung transplantation demonstrating higher incidence of PGD although with equivalent survival compared to standard bilateral lung transplants . Therefore, widespread acceptance of size reduction techniques can allow for more efficient use of available cadaveric donor organs, especially for pediatric recipients, and the need for living donation may be considerably reduced.…”

Section: Size Matchingmentioning

confidence: 99%

The evolving potential for pediatric ex vivo lung perfusion

Luc

Nagendran

2015

Pediatric Transplantation

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Despite the rise in the number of adult lung transplantations performed, rates of pediatric lung transplantation remain low. Lung transplantation is an accepted therapy for pediatric end-stage lung disease; however, it is limited by a shortage of donor organs. EVLP has emerged as a platform for assessment and preservation of donor lung function. EVLP has been adopted in adult lung transplantation and has successfully led to increased adult lung transplantations and donor lung utilization. We discuss the future implications of EVLP utilization, specifically, its potential evolving role in overcoming donor shortages in smaller children and adolescents to improve the quality and outcomes of lung transplantation in pediatric patients.

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Lobar Lung Transplantation From Deceased Donors: A Valid Option for Small-Sized Patients With Cystic Fibrosis

Cited by 23 publications

References 17 publications

Lobar lung transplantation from deceased donors: A systematic review

Lobar lung transplantation from deceased donors: A systematic review

Moving Back to the Future: Use of Organ Care System Lung for Lobectomy Before Lobar Lung Transplantation

The evolving potential for pediatric ex vivo lung perfusion

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