Chest
Donor Selection for Single and Double Lung Transplantation: Chest Size Matching and Other Factors Influencing Posttransplantation Vital Capacity
Section snippets
Patients
Between November 1983 and December 1987, 15 SLTs and seven DLTs were performed at the Toronto (Canada) General Hospital. Thirteen of the 15 SLT recipients had idiopathic pulmonary fibrosis, one had familial pulmonary fibrosis, and one had eosinophilic granuloma. Three of the seven DLT recipients had α1-antitrypsin deficiency emphysema, one had idiopathic emphysema, one had bronchiolitis obliterans, one had eosinophilic granuloma, and one had primary pulmonary hypertension.
Among the 15 SLT
RESULTS
The characteristics of recipients and donors are shown in Table 1. In the SLT group, the age was significantly younger in the donors (30 ± 10 years) than the recipients (48 ± 12 years). Thirteen recipients were male and two were female, whereas eight donors were male and seven were female. Weight, height, and body surface area (BSA) were all significantly smaller in the donors than in the recipients.
In the DLT group, the age of the donors (26 ± 9 years) was also younger than the recipients (37
DISCUSSION
Since 1983, successful SLTs and DLTs have been performed for both severe obstructive and restrictive lung diseases.1, 2, 3, 4, 5, 6 Although both operations lead to substantial improvement in pulmonary function, limited attention has been given to donor-recipient factors that influence the posttransplantation pulmonary function of the recipient.
To our knowledge, the best approach to donor-recipient size matching for lung transplantation has not been determined. A suitable lung donor has
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Cited by (34)
Lung protective ventilation based on donor size is associated with a lower risk of severe primary graft dysfunction after lung transplantation
2021, Journal of Heart and Lung TransplantationCitation Excerpt :Size matching has long been an area of investigation in lung transplantation. In the past, size matching has been evaluated on the basis of height, weight,28 thoracic perimeter,29,30 matching chest radiographs,31,32 and predicted lung size.33 Historically, height has been the most commonly used parameter to size match donors to recipients.
Predictive equations for lung volumes from computed tomography for size matching in pulmonary transplantation
2016, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :These authors also showed an 8% absolute decrease in forced expiratory volume in 1 second/forced vital capacity ratio in the same cohorts. Although other size-matching strategies have sporadically been described, including chest roentgenogram dimensions, inframammary circumference, and vital capacity,15-17 the only other widely used methods are donor pTLC versus recipient pTLC and donor pTLC versus recipient actual TLC. For pTLC, the PFT predictive equations were created based on PFT measurements in a normal population.18-22
Size matching in lung transplantation: An evidence-based review
2013, Journal of Heart and Lung TransplantationCitation Excerpt :This observation is true of all of the studies described in this report. Several studies have reported that recipient post-operative measured TLC or VC has been closely related to the recipient TLC or VC predicted in both BLT4,12,15 and SLT.2,15 Thus, some groups have reported that their matching strategy is to pair donors and recipients based on the closest match between donor pTLC and recipient pTLC.22
Lung size mismatch in bilateral lung transplantation is associated with allograft function and bronchiolitis obliterans syndrome
2012, ChestCitation Excerpt :Expressing allograft function in relation to donor predicted lung function likely captured the actual restriction of an oversized allograft in a smaller recipient's thorax. Prior studies concluded that wide discrepancies in lung sizing do not to influence allograft function.3,4,18–20 In the present study, we also found no difference in allograft function in terms of FVC, FVC (% predicted-recipient), and FEV1.
Comparison of pulmonary function test and computed tomography volumetry in living lung donors
2011, Journal of Heart and Lung TransplantationHow to predict forced vital capacity after living-donor lobar-lung transplantation
2004, Journal of Heart and Lung Transplantation