Lobar Lung Transplantation – Is It Comparable to Standard Lung Transplantation?

Abstract

Purpose Lobar lung transplantation (LLT) is a therapeutic option mainly for urgent small recipients. Only series with limited numbers have been reported. This approach is technically more demanding than standard LuTX or simple downsizing by wedge resections. In our center this approach was liberally applied and we report the largest series of deceased donor LLT so far. Methods and Materials We performed an analysis of our prospective lung transplant database from 1/2001 to 10/2012 and compared the clinical outcome of LLT recipients to those receiving standard donor organs or downsizing by simple peripheral wedge resection. Results 779 LuTX (group 1) were performed either in standard technique (n=542) or with downsizing by wedge resections (n=237). 132 LuTXwere performed in lobar technique (group 2). In group 2 there were significantly more females (57,6% vs. 45,4%; p=0,011). Patients in group 2 were significantly younger (median 36,5 vs. 51,6 years, p Conclusions Patients receiving LLT represent a different patient group than those receiving standard LuTX. The observed outcome is in contrast to previous publications inferior to standard LuTX recipients, which is explained by the different indication spectrum and a higher rate of patients invasively bridged to transplantation. Nevertheless LLT remains a valid and important option in the management of urgent small recipients.