Delayed Chest Closure in Adult Living-donor Lobar Lung Transplantation—A Case Report

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-02-26 DOI:10.1016/j.transproceed.2025.02.002

Marina Nakatsuka , Tatsuaki Watanabe , Chikara Sakai , Yuki Shundo , Yui Watanabe , Hirotsugu Notsuda , Takaya Suzuki , Takashi Hirama , Hisashi Oishi , Hiromichi Niikawa , Masafumi Noda , Yoshinori Okada

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引用次数: 0

Abstract

Delayed chest closure (DCC) is a useful technique in cases with oversized lung grafts, pulmonary edema, and hemodynamic instability. Anatomically oversized lung grafts are potentially problematic in pediatric living-donor lobar lung transplantation (LDLLT), but rarely in an adult LDLLT. We experienced a case of anatomically oversized grafts in the adult LDLLT requiring DCC, although the grafts provided only 57.2% of the recipient's predicted forced vital capacity. Through 3-dimensional computed tomography volumetry, the volume of the donor's right lower lobe was illustrated as 108% of that of the recipient's right hemithorax, the volume of the donor left lower lobe was 143% of that of the recipient's left hemithorax. Her chest was closed without volume reduction 5 days after transplantation. Our experience illustrates the importance of anatomical size-matching even in an adult LDLLT and the usefulness of DCC as a perioperative management modality.

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成人活体供体大叶肺移植延迟闭胸1例报告。

延迟胸闭锁术（DCC）是一种非常有用的技术，用于治疗肺移植物过大、肺水肿和血流动力学不稳定的病例。解剖上过大的肺移植物在儿童活体供体大叶肺移植（LDLLT）中存在潜在问题，但在成人LDLLT中很少出现。我们经历了一例需要DCC的成人LDLLT解剖尺寸过大的移植物，尽管移植物仅提供了受者预测强制肺活量的57.2%。通过三维计算机断层体积测量显示，供体右下叶体积为受体右半胸体积的108%，供体左下叶体积为受体左半胸体积的143%。术后5天闭合胸部，未减容。我们的经验表明，即使在成人LDLLT中，解剖尺寸匹配的重要性以及DCC作为围手术期管理方式的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.