Right to left inverted lobar transplantation

抄録

Right-to-left inverted lobar transplantation is a surgical technique to transplant a donor's right lower lobe to the recipient's left chest, usually in living donor lobar lung transplantation. This technique was developed in Kyoto University by Date and colleagues and is indicated mainly for the following conditions: 1) limited donor lungs' volume relative to the recipient's chest cavity; because the right lower lobe is generally slightly larger than the left lower lobe because of the medial segment (S7), the use of right lower lobe is advantageous. 2) A donor's left-lung anatomy is not suitable for donation, typically peripheral branching of lingular arteries (A4 and/or A5) necessitating vasculoplasty on the donor side, which potentially increases the risk of donor surgery. In addition to the successful case series in Kyoto, we have conducted 3 cases in Tokyo using the technique with a good outcome demonstrating reproducibility of the technique.