Living-donor lobar lung transplantation for various lung diseases.
OBJECTIVE
We report on our early experience in living-donor lobar lung transplantation for patients with various lung diseases including restrictive, obstructive, septic, and hypertensive lung diseases.


METHODS
From October 1998 to March 2002, living-donor lobar lung transplantation was performed in 14 patients with end-stage lung diseases. There were 11 female patients and 3 male patients, with ages ranging from 8 to 53 years, including 4 children and 10 adults. Diagnoses included primary pulmonary hypertension (n = 6), idiopathic interstitial pneumonia (n = 2), bronchiolitis obliterans (n = 2), bronchiectasis (n = 2), lymphangioleiomyomatosis (n = 1), and cystic fibrosis (n = 1). Bilateral living-donor lobar lung transplantation was performed in 13 patients and right single living-donor lobar lung transplantation was performed for a 10-year-old boy with primary pulmonary hypertension.


RESULTS
All the 14 patients are currently alive with a follow-up period of 4 to 45 months. Although their forced vital capacity (1327 +/- 78 mL, 50.2% of predicted) was limited at discharge, arterial oxygen tension on room air (98.5 +/- 1.8 mm Hg) and systolic pulmonary artery pressure (24.8 +/- 1.6 mm Hg) were excellent. Forced vital capacity improved gradually and reached 1894 +/- 99 mL, 67.4% of predicted, at 1 year. All donors have returned to their previous lifestyles.


CONCLUSIONS
Living-donor lobar lung transplantation can be applied to restrictive, obstructive, septic, and hypertensive lung diseases. This type of procedure can be an alternative to conventional cadaveric lung transplantation for both pediatric and adult patients who would die soon otherwise.
Date
Hiroshi
H
Department of Cancer and Thoracic Surgery (Surgery II), Okayama University Graduate School of Medicine and Dentistry, 251 Shikata-Cho, Okayama 700-8558, Japan. hdate@nigeka2.hospital.okayama-u.ac.jp
Aoe
Motoi
M
Nagahiro
Itaru
I
Sano
Yoshifumi
Y
Andou
Akio
A
Matsubara
Hiromi
H
Goto
Keiji
K
Tedoriya
Takeo
T
Shimizu
Nobuyoshi
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D001987:Bronchiectasis / Q000503:physiopathology / Q000601:surgery; D001989:Bronchiolitis Obliterans / Q000503:physiopathology / Q000601:surgery; D002648:Child; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000601:surgery; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000601:surgery; D007564:Japan; D007902:Length of Stay; D019520:Living Donors; D008171:Lung Diseases / Q000503:physiopathology / Q000601:surgery*; D017563:Lung Diseases, Interstitial / Q000503:physiopathology / Q000601:surgery; D008175:Lung Neoplasms / Q000503:physiopathology / Q000601:surgery; D016040:Lung Transplantation; D018192:Lymphangioleiomyomatosis / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D013599:Systole / Q000502:physiology; D012122:Ventilators, Mechanical; D014797:Vital Capacity / Q000502:physiology
D010100:Oxygen