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Right arrow Lung - transplantation

J Thorac Cardiovasc Surg 2001;122:817-818
© 2001 The American Association for Thoracic Surgery

Brief Communications

Living-donor lobar lung transplantation for primary pulmonary hypertension in an adult

Hiroshi Date, MDa, Itaru Nagahiro, MDa, Motoi Aoe, MDa, Hiromi Matsubara, MDb, Kengo Kusano, MDb, Keiji Goto, MDc, Nobuyoshi Shimizu, MDa, Okayama, Japan

From the Departments of Surgery II,a Cardiology,b and Anesthesiology and Resuscitology,c Okayama University School of Medicine, Okayama, Japan.

Received for publication March 16, 2001. Accepted for publication March 19, 2001. Address for reprints: Hiroshi Date, MD, Department of Surgery II, Okayama University School of Medicine, 2-5-1 Shikata-Cho, Okayama 700-8558, Japan (E-mail: hdate@nigeka2.hospital.okayama-u.ac.jp).

In an effort to address the donor shortage issue, living-donor lobar lung transplantation has been performed with satisfactory intermediate survival and functional results.Go 1 Because a limited amount of lung tissue is transplanted, this type of operation seems to be best suited for childrenGo 2 and small adults and has been applied almost exclusively in patients with cystic fibrosis. To our knowledge, this is the first reported case of living-donor lobar lung transplantation for primary pulmonary hypertension (PPH) in an adult.

Clinical summary

A 19-year-old female patient received a diagnosis of PPH in 1996, at the age of 14 years. Continuous intravenous infusion of epoprostenol (prostacyclin) was initiated. After an initial improvement to New York Heart Association class II, her condition began to deteriorate in 1998. Despite high-dose epoprostenol therapy (140-160 ng · kg–1 · min–1), her status deteriorated to class III in 2000. On November 4, massive hemoptysis developed and she was urgently admitted with signs of right-sided heart failure. Right heart catheterization revealed highly elevated pulmonary arterial pressure (systolic/diastolic/mean: 80/40/58 mm Hg) and severely reduced cardiac index (1.4 L · min–1 · m–2. . . [Full Text of this Article]




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