Deceased-donor lobar lung transplant: A successful strategy for small sized recipients

Abstract Objectives Lobar lung transplantation (LLTx) from deceased donors is a potential solution for donor–recipient size mismatch for small sized recipients. We reviewed our institutional experience to compare outcomes after LLTx to standard lung transplantation (LTx). Methods We retrospectively reviewed transplants in our institution from January 2000 to December 2017. LLTx early and long-term outcomes were compared to LTx. Additional analysis considering two eras (Era 1, 2000-2012; Era 2, 2013-2017). Results Among the entire cohort (1665), 75 were LLTx (4.5%). Compared to LTx, LLTx were more frequently bridged to transplant with extracorporeal life support or mechanical ventilation, and transplanted in a rapidly deteriorating status (respectively, 20% vs. 4.4%, p=0.001; 22.7% vs. 7.9, p Conclusions Although lobar lung transplantation is a high-risk procedure, both mid- and long-term survival are comparable to LTx in all cohorts in the modern era. LLTx therefore represents a valuable surgical option for small sized recipients.