Simultaneous pectus excavatum correction and lung transplantation–A case series

Rahimi, Nina; Matilla, José Ramon; Láng, György; Schwarz, Štefan; Nachbaur, Edith; Benazzo, Alberto; Klepetko, Walter; Jaksch, Péter; Höetzenecker, Konrad

doi:10.1111/ajt.16180

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…It is imperative to recognize that in countries with a severe donor shortage, such as Japan, the luxury of awaiting a perfectly matched graft may be infeasible, and decisions regarding graft acceptance must often be expedited, frequently during the initial donor call. Of particular interest, there are reports suggesting the feasibility of concurrently addressing corrective surgery for chest deformity and LTx, potentially rendering this approach a viable therapeutic option, particularly in cases of severe thoracic deformities [ 28 ]. This intriguing avenue warrants further investigation and consideration within the context of LTx.…”

Section: Discussionmentioning

confidence: 99%

Thoracic and vertebral deformities in lung transplantation: perioperative complications and long-term prognoses

Nikkuni,

Hirama,

et al. 2024

BMC Pulm Med

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Background Lung transplantation (LTx) is a crucial therapeutic strategy for patients suffering from end-stage respiratory diseases, necessitating precise donor-recipient size matching to ensure optimal graft function. While standard allocation protocols rely on predicted lung capacity based on factors such as sex, age, and height, a subset of patients with respiratory diseases presents an additional challenge – thoracic or vertebral deformities. These deformities can complicate accurate volume predictions and may impact the success of lung transplantation. Methods In this retrospective cohort study of patients who underwent LTx at Tohoku University Hospital between January 2007 and April 2022, with follow-up until October 2022, the primary objective was to assess the influence of thoracic and vertebral deformities on perioperative complications, emphasizing interventions, such as volume reduction surgery. The secondary objective aimed to identify any noticeable impact on long-term prognoses in recipients with these deformities. Results Of 129 LTx recipients analyzed, 17.8% exhibited thoracic deformities, characterized by pectus excavatum, while 16.3% had vertebral deformities. Perioperative complications, requiring delayed chest closure, tracheostomy, and volume reduction surgery, were more prevalent in the deformity group. Thoracic deformities were notably associated with the need for volume reduction surgery. However, long-term prognoses did not differ significantly between patients with deformities and those without. Vertebral deformities did not appear to significantly impact perioperative or long-term outcomes. Conclusions This study highlights the prevalence of thoracic deformities in LTx recipients, correlating with increased perioperative complications, particularly the potential need for volume reduction surgery. Importantly, these deformities do not exert a significant impact on long-term prognoses. Additionally, patients with vertebral deformities, such as scoliosis and kyphosis, appear to be manageable in the context of LTx.

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Section: Discussionmentioning

confidence: 99%

Thoracic and vertebral deformities in lung transplantation: perioperative complications and long-term prognoses

Nikkuni,

Hirama,

et al. 2024

BMC Pulm Med

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show abstract

“… 1 Recently, this prevailing view has been challenged by some groups that reported satisfactory outcomes of simultaneous repair of pectus excavatum with lung transplantation. 2 , 3 , 4 A case series from the University of Vienna reported 2 pediatric patients who underwent deceased-donor lung transplantation with concomitant Nuss procedure that was performed with 1 or 2 bars. 4 Complications related to bar placement were not reported.…”

Section: Discussionmentioning

confidence: 99%

“… 2 , 3 , 4 A case series from the University of Vienna reported 2 pediatric patients who underwent deceased-donor lung transplantation with concomitant Nuss procedure that was performed with 1 or 2 bars. 4 Complications related to bar placement were not reported. When considering simultaneous correction of pectus excavatum with pediatric living-donor lung transplantation in which large grafts from adult donors are transplanted, Nuss procedure may be preferable to repair without exogenous implants because it enlarges the chest cavity more.…”

Section: Discussionmentioning

confidence: 99%