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- W4224283139 abstract "Introduction Marginal donors reduce the available lung donor pool. End to end anastomosis at bronchus intermedius is the most preferred technique during right lung transplant. We report a new surgical technique of lobar anastomosis that will assist in improving the available lobar lung donor pool through optimum utilization of marginal donors. Case Report This is a 40-year-old female with Primary Ciliary Dyskinesia and hypoxic respiratory failure who underwent bilateral lung transplantation. The donor lung had an Oto lung donor score of 6 indicating nearly marginal donor. Post explantation, the donor right lower lobe was deemed unsuitable secondary to persistent collapse from pneumonia and incomplete inflation during recruitment. Hence, the donor right lower lobe was removed at the origin of the lobar bronchus. As the donor right lung was relatively bigger than the recipient thoracic cage, a bi-lobar donor lung was deemed adequate. In view of potential risk of bronchial stump dehiscence, bronchus intermedius ischemia and resulting bronchomalacia, the anastomosis was done lobe to lobe. The implantation was done by anastomosing the upper lobe to upper lobe bronchus and middle lobe to bronchus intermedius. The vascular anastomosis was performed as per standard protocol. The left lung was transplanted in the routine manner. There was no immediate short term or long-term complications. The bronchoscopy 1-month post-surgery revealed well healed anastomotic areas Summary Lobar anastomosis, although a surgically difficult technique, is a method that can be adopted to ensure adequate utilization of marginal lungs. Marginal donors reduce the available lung donor pool. End to end anastomosis at bronchus intermedius is the most preferred technique during right lung transplant. We report a new surgical technique of lobar anastomosis that will assist in improving the available lobar lung donor pool through optimum utilization of marginal donors. This is a 40-year-old female with Primary Ciliary Dyskinesia and hypoxic respiratory failure who underwent bilateral lung transplantation. The donor lung had an Oto lung donor score of 6 indicating nearly marginal donor. Post explantation, the donor right lower lobe was deemed unsuitable secondary to persistent collapse from pneumonia and incomplete inflation during recruitment. Hence, the donor right lower lobe was removed at the origin of the lobar bronchus. As the donor right lung was relatively bigger than the recipient thoracic cage, a bi-lobar donor lung was deemed adequate. In view of potential risk of bronchial stump dehiscence, bronchus intermedius ischemia and resulting bronchomalacia, the anastomosis was done lobe to lobe. The implantation was done by anastomosing the upper lobe to upper lobe bronchus and middle lobe to bronchus intermedius. The vascular anastomosis was performed as per standard protocol. The left lung was transplanted in the routine manner. There was no immediate short term or long-term complications. The bronchoscopy 1-month post-surgery revealed well healed anastomotic areas Lobar anastomosis, although a surgically difficult technique, is a method that can be adopted to ensure adequate utilization of marginal lungs." @default.
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- W4224283139 date "2022-04-01" @default.
- W4224283139 modified "2023-09-29" @default.
- W4224283139 title "Lobar Anastomosis in Marginal Lung Donors" @default.
- W4224283139 doi "https://doi.org/10.1016/j.healun.2022.01.725" @default.
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