Lobar lung transplantation from deceased donors: A systematic review

• Published in: World journal of transplantation Vol. 7; no. 1; pp. 70 - 80
• Main Authors: Eberlein, Michael, Reed, Robert M, Chahla, Mayy, Bolukbas, Servet, Blevins, Amy, Van Raemdonck, Dirk, Stanzi, Alessia, Inci, Ilhan, Marasco, Silvana, Shigemura, Norihisa, Aigner, Clemens, Deuse, Tobias
• Format: Journal Article
• Language: English
• Published: United States 24-02-2017
• Subjects: Lung size matching; Primary graft dysfunction; Cadaveric lobar lung transplantation; Lobar lung transplantation from deceased donors; Survival
• ISSN: 2220-3230; 2220-3230
• DOI: 10.5500/wjt.v7.i1.70

To systematically review reports on deceased-donor-lobar lung transplantation (ddLLTx) and uniformly describe size matching using the donor-to-recipient predicted-total lung-capacity (pTLC) ratio.
We set out to systematically review reports on ddLLTx and uniformly describe size matching using the donor-to-recipient pTLC ratio and to summarize reported one-year survival data of ddLLTx and conventional-LTx. We searched in PubMed, CINAHL
EBSCO, Cochrane Database of Systematic Reviews
Wiley (CDSR), Database of Abstracts of Reviews of Effects
Wiley (DARE), Cochrane Central Register of Controlled Trials
Wiley (CENTRAL), Scopus (which includes EMBASE abstracts), and Web of Science for original reports on ddLLTx.
Nine observational cohort studies reporting on 301 ddLLTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The ddLLTx-group was often characterized by high acuity; however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pTLC ratio was available for 242 ddLLTx (80%). The mean pTLCratio before lobar resection was 1.25 ± 0.3 and the transplanted pTLCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddLLTx-group ranged from 50%-100%, compared to 72%-88% in the conventional-LTx group. In the largest study ddLLTx (
= 138) was associated with a lower one-year-survival compared to conventional-LTx (
= 539) (65.1%
84.1%,
< 0.001).
Further investigations of optimal donor-to-recipient size matching parameters for ddLLTx could improve outcomes of this important surgical option.