The First Living-Donor Lobar Lung Transplantation in Korea: a Case Report

Abstract

Lung transplantation is the only treatment for end-stage lung disease, but the problem of donor shortage is unresolved issue. Herein, we report the first case of living-donor lobar lung transplantation (LDLLT) in Korea. A 19-year-old woman patient with idiopathic pulmonary artery hypertension received her father's right lower lobe and her mother's left lower lobe after pneumonectomy of both lungs in 2017. The patient has recovered well and is enjoying normal social activity. We think that LDLLT could be an alternative approach to deceased donor lung transplantation to overcome the shortage of lung donors.

Technical Aspects of Lung Transplantation: Pediatric and Lobar Transplantation

“…The first and only living-donor lobar lung transplantation (LDLLT) in Korea was performed on October 21, 2017 at AMC [ 6 ], and it was acknowledged as a legal operation in 2018. The LDLLT procedure for transplanting 2 lower lobes from 2 healthy donors to 1 recipient was developed more than 20 years ago as an alternative to cadaveric lung transplantation (CLT) [ 7 ].…”

“…LDLLT also has advantages in shortening the ischemia time because the lungs are typically removed and transplanted within the same hospital. Furthermore, the lobes from healthy donors continue to function normally without the risk of infection or atelectasis, resulting in fewer postoperative complications, including graft failure or bronchial dehiscence [ 6 ].…”

“…If the combined heart disease is a simple cardiac anomaly such as atrial or ventricular septal defect without Eisenmenger syndrome, lung transplantation can be successfully performed. After full dissection and bleeding control around the mediastinum, heart surgery is typically performed prior to lung transplantation The first and only living-donor lobar lung transplantation (LDLLT) in Korea was performed on October 21, 2017 at AMC [6], and it was acknowledged as a legal operation in 2018. The LDLLT procedure for transplanting 2 lower lobes from 2 healthy donors to 1 recipient was developed more than 20 years ago as an alternative to cadaveric lung transplantation (CLT) [7].…”

Current status of lung transplantation in Korea

“…In 2017, the first living-donor lobar LT (LDLLT) was performed at Asan Medical Center (AMC) (6) in a 19-year-old female patient with idiopathic pulmonary artery hypertension who developed progressive heart failure. Her condition deteriorated rapidly, but no deceased donor could be found.…”