Discussion on right lung volume reduction techniques in lung transplantation surgery
10.12464/j.issn.1674-7445.2025190
- VernacularTitle:肺移植外科手术中右肺减容方式探讨
- Author:
Hongyi WANG
1
;
Yixing LI
1
;
Jinteng FENG
1
;
Heng ZHAO
1
;
Yanpeng ZHANG
1
;
Shan GAO
1
;
Jizhao WANG
1
;
Shuo LI
1
;
Guangjian ZHANG
1
Author Information
1. Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710000, China.
- Publication Type:OriginalArticle
- Keywords:
Lung transplantation;
Surgical volume reduction;
Airway stump fistula;
Lobar transplantation;
Body mass index;
Chronic obstructive pulmonary disease;
Idiopathic pulmonary fibrosis;
Survival rate
- From:
Organ Transplantation
2025;16(6):907-913
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effects of different right lung volume reduction techniques when the donor lung is oversized and mismatched with the recipient. Methods Clinical data of 10 recipients who underwent right lung volume reduction lung transplantation at the First Affiliated Hospital of Xi'an Jiaotong University from October 2022 to June 2024 were collected, including gender, age, primary disease type, and type of transplantation. A retrospective analysis was performed on postoperative complications within 90 days, duration of mechanical ventilation, hospital stay, and survival status to explore the impact of different volume reduction techniques on the survival rate of lung transplant recipients. Results A total of 10 right lung volume reduction recipients were included in this study, with 2 cases of upper lobe reduction, 7 cases of middle lobe reduction, and 1 case of lower lobe reduction. Three recipients developed airway complications (one each with upper, middle, and lower lobe reduction). The 30-day survival rate was 90% and the 1-year survival rate was 70%. One recipient with upper lobe reduction died of septic shock during the perioperative period, one with lower lobe reduction died of airway anastomotic fistula 2 months after surgery, and one with middle lobe reduction died of renal insufficiency 1 year after surgery. All 7 recipients with middle lobe reduction successfully passed the perioperative period, with one case of airway anastomotic stenosis (1/7). The average duration of mechanical ventilation was 71 hours, and the average hospital stay was 26 days. The 30-day survival rate was 7/7, and the 1-year survival rate was 6/7. Conclusions Middle lobe reduction in right lung transplantation surgery has the advantages of low incidence of airway complications, good safety, and minimal loss of lung function, and may be a better right lung volume reduction option with potential for application.
