Living-donor lobar lung transplantation

PURPOSE OF REVIEW: To address the donor shortage issue, living-donor lobar lung transplantations have been performed in some institutions. This paper will review the current status of living-donor lobar lung transplantation. RECENT FINDINGS: Up to 2006, living-donor lobar lung transplantation has been performed in approximately 300 patients worldwide. As only two lobes are transplanted, cystic fibrosis represents the most common indication for living-donor lobar lung transplantation, because patients are usually small in body size. Indications for living-donor lobar lung transplantation have recently been expanded to include paediatric and adult patients with various lung diseases such as idiopathic pulmonary fibrosis and pulmonary arterial hypertension. Survival appears to be similar to or better than International Society for Heart and Lung Transplantation registry data on cadaveric lung transplantation. Living-donor lobar lung transplantation may improve survival after paediatric lung retransplantation. The Vancouver Forum Lung Group proposed the eligibility criteria for living lobar donation. SUMMARY: This procedure can be applied to restrictive, obstructive, infectious, and hypertensive lung diseases for both paediatric and adult patients. As a result of the possible serious complications after donor lobectomy, living-donor lobar lung transplantation should be performed only for very sick patients by a well-prepared programme.