title: Cadaveric lobar lung transplantation: technical aspects.
abstract: BACKGROUND
  The use of lobar transplantation and other size reduction techniques has allowed larger donor lungs to be utilized for smaller recipients who tend to have longer waiting times for transplantation. However, despite these advantages, the techniques have not been widely adopted. We outline the surgical and sizing issues associated with this technique.
  
  
  METHODS
  A retrospective review of 23 consecutive patients who received lung transplantation with anatomic lobar reduction was performed, focusing on surgical technique and outcomes.
  
  
  RESULTS
  All 23 patients received an anatomic lobar reduction of between 1 and 3 lobes. Survival analysis showed no difference between the lobar reduction cohort and the other historically comparable lung transplant patients from our institution (p=0.115). Percent predicted forced vital capacity and forced expiratory volume in 1 second at 3 months correlated with transplanted donor to recipient total lung capacity ratio, confirming the importance of correct sizing.
  
  
  CONCLUSIONS
  Anatomic lobar reduction in lung transplantation is a safe and effective means of transplanting pediatric and small adult recipients, and urgently listed patients.
authors.affiliation: Cardiothoracic Surgery Unit, Department of Respiratory Medicine, The Alfred Hospital, Prahan, Victoria, Australia. s.marasco@alfred.org.au
authors.forename: Silvana F
authors.initials: SF
authors.lastname: Marasco
authors.forename: Stephanie
authors.initials: S
authors.lastname: Than
authors.forename: Dominic
authors.initials: D
authors.lastname: Keating
authors.forename: Glen
authors.initials: G
authors.lastname: Westall
authors.forename: Helen
authors.initials: H
authors.lastname: Whitford
authors.forename: Greg
authors.initials: G
authors.lastname: Snell
authors.forename: Julian
authors.initials: J
authors.lastname: Gooi
authors.forename: Trevor
authors.initials: T
authors.lastname: Williams
authors.forename: Adrian
authors.initials: A
authors.lastname: Pick
authors.forename: Adam
authors.initials: A
authors.lastname: Zimmet
authors.forename: Geraldine A
authors.initials: GA
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D002648:Child; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D016041:Heart-Lung Transplantation / Q000379:methods / Q000401:mortality; D006801:Humans; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors / Q000600:supply & distribution; D014109:Total Lung Capacity / Q000502:physiology; D014797:Vital Capacity / Q000502:physiology; D014850:Waiting Lists