title: Short-term outcome in living donors for lung transplantation: the role of preoperative computer tomographic evaluations of fissures and vascular anatomy.
abstract: Successful living-donor lobar lung transplantation (LDLLT) largely depends on donor outcome. We reviewed our experiences with LDLLT and focused on preoperative computed tomographic evaluations of donors. Twenty-five LDLLTs were performed in Kyoto University. As a routine preoperative assessment, high-resolution chest computed tomography (CT), and three-dimensional (3D)-CT angiography were performed. Preoperative evaluations, surgical procedures, and early postoperative outcomes were reviewed in 43 consecutive LDLLT donors. All donors were discharged home after the donor lobectomies. Severely incomplete fissures were intraoperatively identified in two donors, whose interlobar fissures were mostly not identified by high resolution CT preoperatively. Preoperative 3D-CT angiography was effective for the identification of the branches of the pulmonary artery and vein. Pulmonary arterioplasties were performed with auto pericardial patches in three left donors. The bilateral donors had to be exchanged because of an anomaly of the pulmonary veins in one donor. Small pulmonary arterial branches to the remaining lobes were to be sacrificed in 23 donors (53%). Early postoperative complications were ascertained in seven donors, and five of them presented air leak-related complications. Living donor lobectomies were safely performed with low morbidities in our institution. Preoperative computer tomographic evaluations might be useful in donor lobectomies.
authors.affiliation: Department of Thoracic Surgery and Radiology, Kyoto University, Kyoto, Japan.
authors.forename: Fengshi
authors.initials: F
authors.lastname: Chen
authors.forename: Takuji
authors.initials: T
authors.lastname: Fujinaga
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shoji
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubo
authors.forename: Makoto
authors.initials: M
authors.lastname: Sonobe
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sato
authors.forename: Akihiro
authors.initials: A
authors.lastname: Aoyama
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sato
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sakai
authors.forename: Toru
authors.initials: T
authors.lastname: Bando
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D019520:Living Donors; D008168:Lung / Q000098:blood supply; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome