Initial Experience with Cadaveric Lobar Lung Transplantation in Turkey

Abstract

Introduction: Lung transplantation is the final treatment option for end-stage lung diseases. A scarce donor pool is the primary cause of waiting list mortality. Lobar lung transplantation has been proposed to overcome the donor pool shortage. Herein we present our initial experience with patients who underwent lobar lung transplantation. Patients and Methods: This single-center retrospective study included patients who underwent cadaveric lobar lung transplantation between December 2016 and December 2018 at our Lung Transplant Center. The procedure was performed only in patients with an emergency status. Results: Of the 55 lung transplants during the study period, six [10.9%; four female, two male; median age, 35.3 years (range, 22-42 years)] were lobar lung transplants. The indications were bronchiectasis (three patients), chronic obstructive pulmonary disease (one patient), cystic lung disease (one patient), and lepidic type adenocarcinoma (one patient). The transplantations included bilateral lobar lung in two patients, the right single lung and the left lower lobe in two patients, and the left single lung and the right lower lobe in two patients. One-year mortality was 16.6% (1/6). Two patients died 23 and 24 months after lung transplantation. Three patients were alive at the last follow-up (at 24, 25, 47 months). Conclusion: Lobar lung transplantation can be a life-saving treatment option in critically ill patients with small thoracic cavities to overcome donor shortage. Furthermore, it is a feasible operative technique in recipients with a reduced unilateral thoracic cavity.