Lobar Lung Transplantation: A Single-Center 10-Year Experience

Abstract

IntroductionThe shortage of donors for lung transplant is the main limitation to the preceding. Lobar transplantation is an alternative especially useful in patients with short statute and small thoracic cavities. The aim of this study was to perform a descriptive analysis of Portuguese patients who underwent lobar lung transplantation. MethodsA retrospective study was conducted, and patients submitted to lobar lung transplantation from January 2012 to December 2023 were evaluated. A descriptive analysis was made, including demographic data, lung diseases, waiting list dynamics, pre-transplant evaluations and post-transplant outcomes. ResultsSixteen lobar transplants were performed with a predominance of female patients and median age of 47 years. Most patients had interstitial lung disease or bronchiectasis either due to cystic fibrosis or non-cystic fibrosis. Median pTLC ratio was 0.73. Median waiting list time was 6 months with 9 urgent transplants and 1 emergent lobar retransplant. ECMO was used in pre, intra and postoperative periods. Most transplanted lobes were ML + RUL and LUL. The median length of stay was 58 days with complications such as PDG grade 3, bronchial tree ischemia and concentrical stenosis of bronchial anastomosis. Six patients died in this period, one in the immediate postoperative period and five during the post-transplant hospitalization, with a median survival of 20.7 months and 1-year and 5-year survival rate of 60%. Conclusionour results show a population with increased waiting list converging in many urgent cases, with an early mortality and high PGD rate. Nevertheless, mid-, and long-term survival is promising.