Optimal size matching leads to a favorable outcome for single-lobe living-donor lung transplantation.

Abstract

Living-donor lobar lung transplantation (LDLLT) with a single lobar graft is required when a small pediatric patient receives an oversized graft or only one donor is available. This study aimed to evaluate the posttransplant outcomes of single living-donor lobar lung transplantation (SLDLLT). A total of 110 LDLLTs, including 16 SLDLLTs and 94 bilateral living-donor lobar lung transplantations (BLDLLTs), were performed from 2008 to 2021. Patient characteristics and posttransplant outcomes were compared between the 2 groups. The SLDLLT group included 14 pediatric patients and 2 adult patients, whereas the BLDDT group included 20 pediatric patients and 74 adult patients. Median functional size matching with forced vital capacity was similar between SLDLLT (64.5%; range, 38.0%-94.6%) and BLDLLT (65.2%; range, 37.3%-247.3%) (P = .379). Early posttransplant outcomes did not differ significantly between the 2 groups. Retransplantation was performed in 3 of 4 patients who underwent SLDLLT and 2 of 19 patients who underwent BLDLLT, all of whom developed chronic lung allograft dysfunction. The 5- and 10-year survival rates after SLDLLT were both 93.3% and comparable with those after BLDLLT (P = .057). SLDLLT may produce acceptable short- and long-term posttransplant outcomes when meticulous anatomical and functional size matching is implemented; nevertheless, retransplantation may be required when chronic lung allograft dysfunction develops in a single lobar graft.