BACKGROUND
We have developed a novel method for native upper lobe–sparing living-donor lobar
lung transplantation (LDLLT) to overcome a small-for-size graft in standard LDLLT
with acceptable results. We hypothesized that grafts implanted with this procedure
might work more efficiently than those in standard lobe transplantation.
METHODS
Bilateral LDLLT was performed in 31 patients with a functional graft matching of less
than 60% at our institution between August 2008 and December 2015. Of these, 22 patients
were available for evaluation of pulmonary function more than 1 year later: 15 undergoing
standard LDLLT with less than 60% functional matching and 7 undergoing native upper
lobe–sparing LDLLT.
RESULTS
Overall survival at 2 years was 87.5% in the lobe-sparing LDLLT patients and 79.0%
in the standard LDLLT patients (p = 0.401). The median forced vital capacity size–matching levels were 50.7% ± 1.6%
in the standard LDLLT and 45.2% ± 2.3% in the sparing LDLLT group (p = 0.074). The 1-year and 2-year post-operative volume ratios of inspiration to expiration
were significantly different between the 2 groups, at 1.76 and 1.45 after standard
LDLLT (p = 0.019) vs 2.41 and 2.23 after lobe-sparing LDLLT (p = 0.015).
CONCLUSIONS
The grafts in lobe-sparing LDLLT functioned more effectively than those in standard
LDLLT. This advantage was associated with the improvement of pulmonary functions.
KEY WORDS
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Article Info
Publication History
Published online: September 24, 2018
Identification
Copyright
© 2018 International Society for Heart and Lung Transplantation. All rights reserved.
