Current status and potential of living-donor lobar lung transplantation.

Although cadaveric lung transplantation (CLT) offers acceptable prospects for 5-year survival, chronic rejection and donor shortages remain major problems. In an effort to address the donor shortage issue, living-donor lobar lung transplantations (LDLLT) have been performed in some institutions. As of 2006, LDLLT has been performed in approximately 300 patients worldwide. The survival appears to be similar to or better than International Society for Heart and Lung Transplantation registry data on CLT. Because of the possible serious complications after donor lobectomy, LDLLT should be performed only for very sick patients by a well-prepared program. This type of procedure can be applied to restrictive, obstructive, infectious, and hypertensive lung diseases for both pediatric and adult patients who would die soon otherwise.