title: Graft downsizing during ex vivo lung perfusion: case report and technical notes.
abstract: Among patients with respiratory insufficiency awaiting lung transplantation, small adult patients have a lower opportunity of receiving size-matched pulmonary grafts, because of the shortage of donors, particularly those of small size. Reducing the size of an oversized graft is one of the methods to increase the donor pool; similarly, ex vivo lung perfusion is an emerging technique aimed toward the same purpose. We describe how we combined the 2 techniques (lobar transplantation plus contralateral nonanatomic graft reduction during ex vivo lung perfusion) to overcome graft shortage in a clinical case. For the 1st time, this case report demonstrates that surgical manipulation during ex vivo lung perfusion does not affect the functional improvement in a lung previously judged to be not suitable for transplantation. The 6-month follow-up results are similar to those of standard bilateral lung transplantation.
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Nosotti
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Rosso
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy. Electronic address: paolo.mendogni@unimi.it.
authors.forename: P
authors.initials: P
authors.lastname: Mendogni
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Tosi
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Palleschi
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Righi
authors.affiliation: Department of Anesthesia and Intensive Care, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Froio
authors.affiliation: Department of Anesthesia and Intensive Care, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Valenza
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, Scientific Institute for Research Hospitalization and Health Care, "Ca' Granda" General Hospital, University of Milan, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Santambrogio
mesh_terms: D000328:Adult; D006801:Humans; D008168:Lung / Q000033:anatomy & histology* / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010477:Perfusion