Optimal size matching in single lung transplantation.
BACKGROUND
Single lung transplantation for patients with end-stage obstructive lung disease has been highly effective in providing symptomatic relief, and it has been performed at a much increased frequency since 1983. However, there still lacks a convincing study showing the effect of size match and other preoperative variables in predicting functional outcome of patients after transplantation.


METHODS
We evaluated 23 single lung transplantations performed for obstructive lung disease over a 34-month period. Multiple physiologic variables and size match criteria were evaluated for their contribution in determining the postoperative forced expiratory volume in 1 second at 3 months after transplantation.


RESULTS
The size match ratio that was based on inframammary chest wall circumference was the most useful criterion to adopt, and the optimal donor/recipient size match ratio was 0.89. Furthermore, forced expiratory volume in 1 second at 3 months after transplantation could be predicted with a simple mathematical model that was based on the size match ratio and the recipient's calculated vital capacity of the transplanted hemithorax.


CONCLUSIONS
This model could be applied in a clinical setting to maximize functional outcome of the recipients undergoing single lung transplantation.
Park
S J
SJ
Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, Ill 60153, USA.
Houck
J
J
Pifarre
R
R
Sullivan
H
H
Garrity
E
E
Kim
S Y
SY
Zbilut
J
J
Montoya
A
A
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000601:surgery*; D016040:Lung Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009929:Organ Size / Q000502:physiology; D011183:Postoperative Complications / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D014019:Tissue Donors; D014797:Vital Capacity / Q000502:physiology