Postoperative pulmonary function and complications in living-donor lobectomy.
BACKGROUND
Successful living-donor lobar lung transplantation largely depends on the donor's outcome. Because surgical skills and peri-operative management have evolved over time, this study evaluated the recent outcomes of donor lobectomies.


METHODS
Between 2008 and 2014, 48 consecutive living-donor lobar lung transplantations with 85 donor lobectomies were performed at Kyoto University. All donors were prospectively followed up regularly until 1 year after surgery.


RESULTS
Right and left lower lobectomies were performed in 49 and 36 donors, respectively. Pulmonary arterial branches were sacrificed at equal frequency in both lobectomies, whereas pulmonary arterioplasty was only performed in left lower lobectomy (n = 9). All donors were discharged after the lobectomies, and none died during follow-up. Post-operative complications occurred in 24 donors (28%) overall, without a significant difference between donor sides. Intraoperative complications were found in 2 donors. Early and late post-operative complications were noted in 17 and 6 donors, respectively. Pneumothorax, pleuritis, and pleural effusion were the most frequent. Post-operative pulmonary function sequentially recovered more than expected and was not significantly affected by the sacrifice of pulmonary arterial branches during lobectomy. By contrast, pulmonary function at 1 year after donor lobectomy in the donors who had peri-operative complications was significantly lower than that in the donors who did not, although even post-operative pulmonary function in the donors with peri-operative complications still recovered more than expected.


CONCLUSIONS
Living-donor lobectomies have been safely performed in recent decades with low morbidities and without mortality.
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Fengshi
F
Chen
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Tetsu
T
Yamada
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Masaaki
M
Sato
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Akihiro
A
Aoyama
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Akihiro
A
Takahagi
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Toshi
T
Menju
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Toshihiko
T
Sato
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Makoto
M
Sonobe
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Mitsugu
M
Omasa
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan. Electronic address: hdate@kuhp.kyoto-u.ac.jp.
Hiroshi
H
Date
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007564:Japan; D019520:Living Donors; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D020127:Recovery of Function; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
computed tomography; donor; living-donor lobar lung transplantation; lobectomy; preoperative evaluation