Living donor lung transplantation

Since 1993 a total of 101 living-donor bilateral lung transplants have been performed with acceptable results when compared with those utilizing cadav eric lung grafts. Though most recipients were patients with cystic fibrosis who mere rapidly deteriorating, the indications for live-donor lung transp lantation have been expanded to include some cystic fibrosis patients in a more elective setting, as well as select patients with other end-stage pulm onary diseases. One-gear Kaplan-Meier recipient survival is 72%. Seventy-si x percent of deaths occur within the first 2 months after transplantation. The most common cause of death is infection, which accounts for 62% of the 1-year mortality rate. The incidence of rejection is 0.8 episodes per patie nt. Thirty percent of rejection episodes are unilateral, and most tend to b e mild. Altogether, 203 patients have undergone donor lobectomy, with a mea n age of 37 +/- 12 years (range 18-56 years). Operations included left lowe r lobectomy (102 patents), right lower lobectomy (97 patients), and right m iddle and lower lobectomy (4 patients). There has been no donor mortality. Postoperative Rand 36 Question Quality of Life scores, rating physical func tion, social functioning, and role limitation due to physical and emotional health, are well over 92 (of a possible score of 100). Eighty-five percent of donors said that their health was no different or improved since donati on.