Downsizing cadaveric lung transplantation

• Published in: Japanese Journal of Transplantation Vol. 58; no. Supplement; p. s143_2
• Main Authors: Seiichiro, SUGIMOTO, CHOSHI, Haruki, TANAKA, Shin, ISHIHARA, Megumi, HASHIMOTO, Kohei, SUZAWA, Ken, SHIEN, Kazuhiko, MIYOSHI, Kentaroh, YAMAMOTO, Hiromasa, OKAZAKI, Mikio, TOYOOKA, Shinichi
• Format: Journal Article
• Language: English
• Published: The Japan Society for Transplantation 2023
• ISSN: 0578-7947; 2188-0034
• DOI: 10.11386/jst.58.Supplement_s143_2

BACKGROUND: Since donation after cardiac death is not approved for lung transplantation (LT) in Japan, maximizing the utilization of extended criteria donor lungs is essential to solve donor shortage. Among various techniques in LT, we describe our experience of downsizing cadaveric LT (DCLT).METHODS: We retrospectively reviewed 17 recipients who underwent DCLT among 218 recipients of LT at our institution.RESULTS: DCLT was performed for 10 female and 7 male patients ranging in age from 9 to 55 years. The diagnoses included interstitial pneumonia (n = 9), diffuse panbronchiolitis (n = 2), pulmonary hypertension (n = 2) and others (n = 4). The median waiting time was 467 (53-1029) days. Bilateral LT was performed after uni-lobectomy (n = 11) or multi-lobectomy (n = 6). The cause of lobectomy was pneumonia (n = 8), oversized graft (n = 5), and trauma (n = 4). Bronchial stenosis was observed in one of 4 bronchial stumps, whereas no complication developed in 13 lobar-to-lobar bronchial anastomoses. The 5- and 10-year overall survival rates were 78.7% and 78.7%, respectively.CONCLUSION: DCLT provided favorable long-term outcomes and appears to be a viable option for selected patients.