Date Hiroshi, Aoe Motoi, Nagahiro Itaru, Sano Yoshifumi, Andou Akio, Matsubara Hiromi, Goto Keiji, Tedoriya Takeo, Shimizu Nobuyoshi
Department of Cancer and Thoracic Surgery (Surgery II), Okayama University Graduate School of Medicine and Dentistry, 251 Shikata-Cho, Okayama 700-8558, Japan.
J Thorac Cardiovasc Surg. 2003 Aug;126(2):476-81. doi: 10.1016/s0022-5223(03)00235-6.
We report on our early experience in living-donor lobar lung transplantation for patients with various lung diseases including restrictive, obstructive, septic, and hypertensive lung diseases.
From October 1998 to March 2002, living-donor lobar lung transplantation was performed in 14 patients with end-stage lung diseases. There were 11 female patients and 3 male patients, with ages ranging from 8 to 53 years, including 4 children and 10 adults. Diagnoses included primary pulmonary hypertension (n = 6), idiopathic interstitial pneumonia (n = 2), bronchiolitis obliterans (n = 2), bronchiectasis (n = 2), lymphangioleiomyomatosis (n = 1), and cystic fibrosis (n = 1). Bilateral living-donor lobar lung transplantation was performed in 13 patients and right single living-donor lobar lung transplantation was performed for a 10-year-old boy with primary pulmonary hypertension.
All the 14 patients are currently alive with a follow-up period of 4 to 45 months. Although their forced vital capacity (1327 +/- 78 mL, 50.2% of predicted) was limited at discharge, arterial oxygen tension on room air (98.5 +/- 1.8 mm Hg) and systolic pulmonary artery pressure (24.8 +/- 1.6 mm Hg) were excellent. Forced vital capacity improved gradually and reached 1894 +/- 99 mL, 67.4% of predicted, at 1 year. All donors have returned to their previous lifestyles.
Living-donor lobar lung transplantation can be applied to restrictive, obstructive, septic, and hypertensive lung diseases. This type of procedure can be an alternative to conventional cadaveric lung transplantation for both pediatric and adult patients who would die soon otherwise.
我们报告了对患有包括限制性、阻塞性、脓毒性和高血压性肺病等各种肺病的患者进行活体供体肺叶移植的早期经验。
1998年10月至2002年3月，对14例终末期肺病患者进行了活体供体肺叶移植。其中女性患者11例，男性患者3例，年龄8至53岁，包括4名儿童和10名成人。诊断包括原发性肺动脉高压（n = 6）、特发性间质性肺炎（n = 2）、闭塞性细支气管炎（n = 2）、支气管扩张症（n = 2）、淋巴管平滑肌瘤病（n = 1）和囊性纤维化（n = 1）。13例患者接受了双侧活体供体肺叶移植，1例10岁原发性肺动脉高压男孩接受了右侧单肺活体供体肺叶移植。
14例患者目前均存活，随访时间为4至45个月。虽然他们出院时的用力肺活量（1327±78 mL，占预计值的50.2%）有限，但室内空气中的动脉血氧分压（98.5±1.8 mmHg）和收缩期肺动脉压（24.8±1.6 mmHg）良好。用力肺活量逐渐改善，1年时达到1894±99 mL，占预计值的67.4%。所有供体均已恢复至术前生活方式。
活体供体肺叶移植可应用于限制性、阻塞性、脓毒性和高血压性肺病。对于否则将很快死亡的儿童和成人患者，这种手术类型可以作为传统尸体肺移植的替代方法。
