Right-to-left inverted single lung transplantation

Abstract

Right-to-left inverted single-lung transplantation procedure via an open-space technique. CENTRAL MESSAGE Right-to-left inverted single lung transplantation is anatomically feasible. An open space behind the bronchi can be made for pulmonary artery anastomosis by pulling both up. See Commentary on page XXX.

Commentary: Up, down, right, left: Addressing the shortage of donor lungs for transplantation

“…The report from Chida and colleagues 1 is an impressive technical feat, and the authors should be congratulated on the successful implementation of this technique. However, given the relative number of donors and recipients in the United States, the applicability of a complex technique is questionable in this country, when simply making the decision to use a greater number of standard donors would suffice.…”

“…As a result, Japanese lung transplant surgeons are renown for their creativity and technical prowess in addressing this shortage. Chida and colleagues 1 from Dokkyo Medical University School of Medicine detail their technique of right-to-left inverted single lung transplantation—an extension of the work that has been done in Japan to pioneer living donor lung transplantation and other techniques to address the donor shortage. They should be commended for describing this complex, technical operation.…”

Right lung transplantation with a left-to-right inverted anastomosis in a rat model

“… 9 , 10 The core of this procedure involved implanting an inverted right lower lobe into the left thoracic cavity, inspiring the current right LTx model. 11 , 12 Compared with traditional LTx, the mechanisms of postoperative pathophysiological variations in inverted LTx are not well understood and include ischemia–reperfusion injury (IRI), acute rejection (AR), and chronic rejection (CR). Experimental animal models have laid a solid and necessary foundation for the further study of left-to-right LTx.…”

Commentary: How to avoid vascular kinking in implanting a contralateral lung graft

“…In this issue of the Journal , Chida and colleagues 5 report a precise technique of implanting the donor's right lung graft into the recipient's left chest cavity. The sequence of the anastomosis that they describe is unique, in that the pulmonary artery anastomosis was performed first.…”