Native Lung-sparing Lobar Transplantation for Pulmonary Emphysema

Yamane, Masaomi; Okutani, Daisuke; Sugimoto, Seiichiro; Toyooka, Shinichi; Aoe, Motoi; Okazaki, Masaharu; Sano, Yoshifumi; Date, Hiroshi

doi:10.1016/j.healun.2008.05.025

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…To rescue such patients with small lobar grafts, we performed five LDLLTs with the native upper lobes spared and evaluated the short‐ and mid‐term outcomes. A canine model and a few cases have been reported, convincing us that sparing the upper lobes in LDLLT is a feasible option, at least in short time periods .…”

Section: Discussionmentioning

confidence: 81%

“…A native lobe‐sparing lobar transplant technique was reportedly feasible in a canine model . The first unilateral native lobe‐sparing lobar lung transplantation for emphysema was reported in 2006 . We also reported a successful case of a bilateral native lobe‐sparing LDLLT in 2011 , and to date, this novel strategy has been applied to five LDLLTs that would otherwise be very challenging because of small grafts.…”

Section: Introductionmentioning

confidence: 87%

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Sparing Native Upper Lobes in Living-Donor Lobar Lung Transplantation: Five Cases From a Single Center

Aoyama

Chen

Minakata

et al. 2015

American Journal of Transplantation

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Living-donor lobar lung transplantation (LDLLT) is indicated for rapidly deteriorating patients, and the total volume of two lower lobe grafts must be sufficient for the recipient. To rescue patients with small lobar grafts, we performed five LDLLTs sparing native upper lobes. This strategy was used when upper lobes or segments were preoperatively less impaired. There were no hospital deaths. Extracorporeal circulation time and operative time were similar to those of conventional LDLLTs. The length of intensive care unit stay was also similar. Late complications attributed to the spared lungs were airway infection in one recipient and pneumothorax in two but they were successfully managed. All recipients were discharged without supplemental oxygen. The spared lung volumes measured by volumetry did not change after LDLLT. Lung perfusion scintigraphy performed at 1 year showed remaining perfusion in the spared lungs, although much less than in the grafts. These results suggested that the spared lobes kept adequate space in the thoracic cavity and kept functioning to a limited extent. The new lobar-sparing strategy appears feasible and effective in LDLLT using small grafts for selected patients when the upper lobes or segments are less impaired.Abbreviations: BO, bronchiolitis obliterans; CPB, cardiopulmonary bypass; CHP, chronic hypersensitivity pneumonitis; %DLCO, diffusing capacity of the lung for carbon monoxide; ECMO, extracorporeal membrane oxygenation; FVC, forced vital capacity; HRCT, highresolution computed tomography; ICU, intensive care unit; IIP, idiopathic interstitial pneumonia; IPAH, idiopathic pulmonary arterial hypertension; LDLLT, living-donor lobar lung transplantation; PAP, pulmonary artery pressure; PGD, primary graft dysfunction; PVR, pulmonary vascular resistance; Tc99-MAA, Tc-99 macroaggregated albumin

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 87%

Sparing Native Upper Lobes in Living-Donor Lobar Lung Transplantation: Five Cases From a Single Center

Aoyama

Chen

Minakata

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…5 Yamane et al reported a clinical case in which the right upper lobe with a relatively normal parenchyma was spared in LDLLT for severe pulmonary emphysema. 6 Our primary purpose for sparing the bilateral native upper lobes in the present case was not to preserve native lung function but to reduce intrathoracic dead space, and thus to provide adequate chest cavity for small grafts. As post-operative perfusion/ventilation scintigraphy demonstrated, native spared lungs showed marked air trapping and received very little blood flow.…”

Section: Discussionmentioning

confidence: 96%