Excellent outcome of donor lobectomy with various surgical techniques for the interlobar artery†.

OBJECTIVES: Donor lobectomies in living-donor lobar lung transplantation sometimes require additional surgical procedures on the interlobar pulmonary artery. We retrospectively reviewed the surgical techniques and outcomes of living-donor lobectomy.

METHODS: Between 2008 and 2015, 116 living-donor lobectomies were performed in 64 consecutive living-donor lobar lung transplantations (52 bilateral, 12 single). The surgical techniques and outcomes were reviewed retrospectively.

RESULTS: Right lower lobectomies were performed in 69 donors, left lower lobectomies in 45 and middle lobectomies in 2. In 61 living donors (52.6%), small branches of the pulmonary artery were sacrificed for anatomical reasons. Pulmonary arterioplasties to preserve the pulmonary artery branches were performed in 13 donors (11.2%). Thirteen left lower lobectomies with pulmonary arterioplasty were performed to preserve lingular branches, as the lingular branch originated far distal to the superior segmental branch of the left lower lobe. Pulmonary arterioplasty with an autologous pericardial patch in 10 donors and with an end-to-end anastomosis in three donors was performed. All surgical procedures had no complications. Three months after lobectomy, the ratio of the pulmonary function test results to the preoperative values and the complication rate showed no significant differences between donors with and without pulmonary arterioplasties, and donors with and without sacrifice of small branches. All living donors resumed their previous lifestyles without restriction.

CONCLUSIONS: Although additional surgical procedures were often required in living-donor lobectomies, the donor outcomes were satisfactory. Arterioplasty to close the interlobar artery in the donor was needed in left-sided cases only.