Hidenao Kayawake, Satona Tanaka, Yoshito Yamada, Shiro Baba, Hideyuki Kinoshita, Kazuhiro Yamazaki, Tadashi Ikeda, Kenji Minatoya, Yojiro Yutaka, Masatsugu Hamaji, Akihiro Ohsumi, Daisuke Nakajima, Hiroshi Date
Kyoto University. Kobe City Medical Center General Hospital.
Japan
European Journal of Cardiothoracic Surgery
Eur J Cardiothorac Surg 2023;
DOI: 10.1093/ejcts/ezad024
Abstract
Objectives: Living-donor lobar lung transplantation (LDLLT) is a life-saving procedure for critically ill patients with various lung diseases, including pulmonary hypertension. However, there are concerns regarding the development of heart failure with pulmonary oedema after LDLLT in which only one or two lobes are implanted. This study aimed to compare the preoperative conditions and postoperative outcomes of LDLLT with those of cadaveric lung transplantation (CLT) in pulmonary hypertension patients.
Methods: Between 2008 and 2021, 34 lung transplants for pulmonary hypertension, including 12 LDLLTs (five single and seven bilateral) and 22 bilateral CLTs, were performed. Preoperative variables and postoperative outcomes were retrospectively compared between the two procedures.
Results: Based on the preoperative variables of less ambulatory ability (41.7% vs 100%, p < 0.001), a higher proportion of WHO class 4 (83.3% vs 18.2%, p < 0.001), and higher mean pulmonary artery pressure (74.4 mmHg vs 57.3 mmHg, p = 0.040), LDLLT patients were more debilitated than CLT patients. Nevertheless, hospital death was similar between the two groups (8.3% vs 9.1%, p > 0.99, respectively). Furthermore, the 5-year overall survival rate was similar between the two groups (90.0% vs 76.3%, p = 0.489).
Conclusions: Although LDLLT patients with pulmonary hypertension had worse preoperative conditions and received smaller grafts than CLT patients, LDLLT patients demonstrated similar perioperative outcomes and prognoses as CLT patients. LDLLT is a viable treatment option for patients with pulmonary hypertension.
Category
Lung Transplantation for Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
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