Favorable outcomes after living-donor lobar lung transplantation in ventilator-dependent patients.
OBJECTIVE
Living-donor lobar lung transplantation (LDLLT) is performed in critically ill patients, although the outcome is generally expected to be poor for those who are ventilator dependent. The aim of this study was to compare the outcomes of LDLLT in ventilator-dependent patients compared with those in ventilator-independent patients.


METHODS
We reviewed 31 consecutive patients who received LDLLT between October 1998 and May 2004.


RESULTS
Five patients were ventilator dependent and 26 were ventilator independent. All five ventilator-dependent patients were female, with a mean age of 29.6 years. The duration of preoperative ventilation was 23.4 +/- 5.7 days. The underlying diagnoses in the ventilator-dependent patients included only obstructive (n = 3) and infectious lung diseases (n = 2), whereas those in the ventilator-independent patients included hypertensive and restrictive diseases (P = 0.004). There were no significant differences between the groups in early postoperative clinical values. The incidences of acute rejection and bronchiolitis obliterans syndrome (BOS) were comparable. The 5-year survival rates were 100% for the ventilator-dependent patients and 92.3% for the ventilator-independent patients (P = 0.45).


CONCLUSIONS
Our findings suggest that LDLLT can have a favorable outcome in selected ventilator-dependent patients.
Toyooka
Shinichi
S
Department of Cancer and Thoracic Surgery, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Yamane
Masaomi
M
Oto
Takahiro
T
Sano
Yoshifumi
Y
Okazaki
Megumi
M
Hanazaki
Motohiko
M
Goto
Keiji
K
Date
Hiroshi
H
D000328:Adult; D001989:Bronchiolitis Obliterans / Q000453:epidemiology; D005260:Female; D006801:Humans; D019520:Living Donors; D008171:Lung Diseases / Q000601:surgery; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012121:Respiration, Artificial; D055815:Young Adult