Techniques and results of lobar lung transplantations

Mitilian, Délphine; Sage, Édouard; Puyo, Philippe; Bonnette, P.; Parquin, François; Stern, M.; Fischler, Marc; Chapelier, Alain

doi:10.1093/ejcts/ezt353

Cited by 47 publications

(30 citation statements)

References 13 publications

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“…In deceased-donor lung transplantation, several surgical modifications have been performed to counter the severe donor shortage worldwide, such as pulmonary bipartitioning, lobar transplantation, and inverted left lung transplantation into the right thorax (12)(13)(14)(15)(16). In LDLLT, native lungsparing bilateral LDLLT and single LDLLT with contralateral lung resection also have been reported (17,18); however, there are no reports of right and left inverted lobar lung transplantation.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Right and Left Inverted Lobar Lung Transplantation

Chen

Miyamoto

Takemoto

et al. 2015

American Journal of Transplantation

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“…In contrast, elevated pulmonary artery pressures were reported in the setting of undersized pediatric and adult lobar lung transplantation 19,24 . Elevated pulmonary artery pressures at the time of transplant were identified as a risk factor for PGD 2,10 .…”

Section: Discussionmentioning

confidence: 99%

“…However, there are opinions published that significantly oversized allografts are associated with increased perioperative complications and worse outcomes 24,28 . Contrary to these concerns, in a porcine model of LTx, a 1.8-fold oversized allograft was compared with a size-matched allograft and the oversized graft was associated with superior function 23 .…”

Section: Discussionmentioning

confidence: 99%

“…Information on lung trimming or lobar resection was not captured in the dataset; however, lobar lung transplants were excluded a priori. Confounding by unmeasured trimming would likely bias oversizing towards an increased risk of PGD3 in oversized lungs 24,28 . Furthermore, uncontrolled confounding is possible; however, we included all known PGD risk factors in this analysis.…”

Section: Discussionmentioning

confidence: 99%

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Lung Size Mismatch and Primary Graft Dysfunction after Bilateral Lung Transplantation

Eberlein

Reed

Bölükbas

et al. 2013

The Journal of Heart and Lung Transplantation

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“…Clam-shell bilateral thoracotomies with transverse division of the sternum is used for bilateral sequential lung transplant procedures [20]. They have been used on occasion for complex reconstructions of the aorta from the aortic root to the descending thoracic aorta.…”

Section: Thoracotomy Approachesmentioning

confidence: 99%

Access to the Heart – Evolution of surgical techniques

Raman¹

2015

Glob Surg

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Access to the heart and closure of the resultant incisions and wounds have been considered major impediments to the growth of cardiac surgery. Nevertheless, during the 1980s and 1990s, the sternotomy was the most commonly performed surgical access procedure in the world. We discuss the evolution of various techniques to allow access to the heart and surrounding structures. Methods of closure of these incisions are also highlighted as these techniques evolve.

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Techniques and results of lobar lung transplantations

Abstract: LLTs are a reliable solution and can be performed with satisfactory functional results and survival rates.

Cited by 47 publications

References 13 publications

Right and Left Inverted Lobar Lung Transplantation

Right and Left Inverted Lobar Lung Transplantation

Lung Size Mismatch and Primary Graft Dysfunction after Bilateral Lung Transplantation

Access to the Heart – Evolution of surgical techniques

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