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Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie

24.-26.10.2013, Basel, Schweiz

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Living-Related Lobar Lung Transplantation – Experience at the Department of Thoracic Surgery Vienna

Meeting Abstract

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  • V. Pradl - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • T. Klikovits - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • P. Jaksch - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • G. Muraközy - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • C. Aigner - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • G. Lang - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • J. Matilla - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • S. Taghavi - Department of Thoracic Surgery, Medical University of Vienna, Vienna
  • W. Klepetko - Department of Thoracic Surgery, Medical University of Vienna, Vienna

Deutsche Gesellschaft für Thoraxchirurgie. Österreichische Gesellschaft für Thoraxchirurgie. Schweizerische Gesellschaft für Thoraxchirurgie. Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie. Basel, Schweiz, 24.-26.10.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocS5.4

doi: 10.3205/13dgt044, urn:nbn:de:0183-13dgt0444

Published: October 14, 2013

© 2013 Pradl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Living-related lobar lung transplantation is an alternative to cadaveric lung transplantation especially for patients in very urgently need for an organ. The advantages of a LRLLT are the elimination of the waiting period and the short time of cold ischemia. At the Department of Thoracic Surgery, General Hospital Vienna, five patients underwent LRLLT since 1999.

Methods: Four patients suffered from end-stage cystic fibrosis and one child from Graft-versus-Host disease and were therefore urgently waiting for a donor lung. The rapid decline in the patients’ pulmonary status and the accordance of the parents to donate a lobe led to the LRLLTs. In four cases each mother donated her left lower lobe, whereas each father donated his right lower lobe. The GvHD patient just received the right lower lobe from his mother.

Results: At the Department of Thoracic Surgery Vienna, the first LRLLTs were performed in 1999 respectively 2001. There were no surgical complications nevertheless both patients passed away three months postoperatively based on problems inherent with CF. However, after re-initiation of our LRLLT program in 2009 no further patient died. In 2009 a 7-year-old boy suffered from severe GvHD of the lung after stem cell transplantation. For size reasons it was necessary to perform a single LRLLT and a left-sided pneumonectomy using just the right lower lobe from his mother. In 2012, two end-stage CF patients underwent bilateral LRLLT. One of those patients was intubated for three days and bridged to LRLLT with extracorporeal membrane oxygenation support. During the follow-up time all recipients and donors showed good postoperative functional tests. Donors had no surgical complications and no mortality.

Conclusion: In the absence of cadaveric organs LRLLT is a possibility to safe severely ill patients’ life in an urgent time frame. A continuous follow-up program for recipients as well as for donors has to be established.