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J Thorac Cardiovasc Surg 2003;126:476-481
© 2003 The American Association for Thoracic Surgery

Cardiothoracic transplantation

Living-donor lobar lung transplantation for various lung diseases

^a Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
^b Department of Cardiology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
^c Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
^d Department of Cardiovascular Surgery,^d Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan

Received for publication January 29, 2002; revisions received May 15, 2002; revisions received August 6, 2002; accepted for publication August 15, 2002.

^* Address for reprints: Hiroshi Date, MD, Department of Cancer and Thoracic Surgery (Surgery II), Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-Cho, Okayama 700-8558, Japan
hdate{at}nigeka2.hospital.okayama-u.ac.jp

OBJECTIVE: We report on our early experience in living-donor lobar lung transplantation for patients with various lung diseases including restrictive, obstructive, septic, and hypertensive lung diseases.

METHODS: From October 1998 to March 2002, living-donor lobar lung transplantation was performed in 14 patients with end-stage lung diseases. There were 11 female patients and 3 male patients, with ages ranging from 8 to 53 years, including 4 children and 10 adults. Diagnoses included primary pulmonary hypertension (n = 6), idiopathic interstitial pneumonia (n = 2), bronchiolitis obliterans (n = 2), bronchiectasis (n = 2), lymphangioleiomyomatosis (n = 1), and cystic fibrosis (n = 1). Bilateral living-donor lobar lung transplantation was performed in 13 patients and right single living-donor lobar lung transplantation was performed for a 10-year-old boy with primary pulmonary hypertension.

RESULTS: All the 14 patients are currently alive with a follow-up period of 4 to 45 months. Although their forced vital capacity (1327 ± 78 mL, 50.2% of predicted) was limited at discharge, arterial oxygen tension on room air (98.5 ± 1.8 mm Hg) and systolic pulmonary artery pressure (24.8 ± 1.6 mm Hg) were excellent. Forced vital capacity improved gradually and reached 1894 ± 99 mL, 67.4% of predicted, at 1 year. All donors have returned to their previous lifestyles.

CONCLUSIONS: Living-donor lobar lung transplantation can be applied to restrictive, obstructive, septic, and hypertensive lung diseases. This type of procedure can be an alternative to conventional cadaveric lung transplantation for both pediatric and adult patients who would die soon otherwise.

Key Words: 12