title: Lobar lung transplantation from deceased donors: a valid option for small-sized patients with cystic fibrosis.
abstract: BACKGROUND
  Small-sized patients with cystic fibrosis usually face long waiting times for a suitable lung donor. Reduced-size lung transplantation (LTx) was promoted to shorten waiting times. We compared donor and recipient characteristics and outcome in lobar ([L]) versus full-size ([FS]) lung recipients.
  
  
  METHODS
  Between July 1, 1991, and February 28, 2011, 535 isolated LTx were performed, including 74 in cystic fibrosis patients (8 L, 66 FS). Patients were followed up until September 2012.
  
  
  RESULTS
  [L] recipients were younger, smaller, and lighter. Sex, waiting times, and donor data (age, sex, height, weight, PaO2/FiO2, and ventilation time) were comparable. Cardiopulmonary bypass was used more often in [L]; cold ischemia was comparable for first lung but longer in [L] for second lung; implantation times were comparable. In-hospital mortality rate was 0% in [L] versus 3% in [FS]. Both intensive care unit and hospital stay were longer in [L]. Grade 3 primary graft dysfunction was more pronounced in [L] at T0 and at T48. FEV1 increased significantly in both groups from preoperative value. Bronchiolitis obliterans syndrome was absent in [L] and diagnosed in 18 patients in [FS], accounting for 6 of 15 late deaths. All [L] are still alive. No differences in survival were found between the groups.
  
  
  CONCLUSIONS
  Although hindered by a higher incidence of primary graft dysfunction, L-LTx is a viable option with excellent survival and pulmonary function comparable to FS-LTx.
authors.affiliation: Department of Thoracic Surgery, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Stanzi
authors.affiliation: Department of Thoracic Surgery, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Decaluwe
authors.affiliation: Department of Thoracic Surgery, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Coosemans
authors.affiliation: Department of Thoracic Surgery, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: De Leyn
authors.affiliation: Department of Thoracic Surgery, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Nafteux
authors.affiliation: Department of Thoracic Surgery, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Van Veer
authors.affiliation: Department of Pneumology, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Dupont
authors.affiliation: Department of Pneumology, University Hospitals Gasthuisberg, Leuven, Belgium.
authors.forename: G M
authors.initials: GM
authors.lastname: Verleden
authors.affiliation: Department of Thoracic Surgery, University Hospitals Gasthuisberg, Leuven, Belgium; Laboratory for Experimental Thoracic Surgery, Katholieke Universiteit, Leuven, Belgium. Electronic address: dirk.vanraemdonck@uzleuven.be.
authors.forename: D
authors.initials: D
authors.lastname: Van Raemdonck
mesh_terms: D000293:Adolescent; D000328:Adult; D001989:Bronchiolitis Obliterans / Q000209:etiology; D003550:Cystic Fibrosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008168:Lung / Q000473:pathology; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D018579:Patient Selection; D055031:Primary Graft Dysfunction / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult