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Whole-Lung vs Lobe Transplantation for Adults

Bertrand J. Shapiro, MD; Kevin M. Chan, MD; Richard G. Barbers, MD; Vaughn A. Starnes, MD
Arch Intern Med. 1996;156(8):908. doi:10.1001/archinte.1996.00440080110013.
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In the September 11, 1995, issue of the ARCHIVES, Kramer and Sprung1 described a 28-year-old man with bronchiolitis obliterans and pneumonia who was considered for a bilateral whole-lung transplantation from living related donors. It was thought that whole lungs were necessary to support an adult recipient's ventilation. Kramer and Sprung indicated that, to their knowledge, living donor whole-lung transplantation from one adult to another has never been performed. Therefore, because of lack of experience, the transplantation was not performed, and the patient ultimately died.

Kramer and Sprung knew of Starnes and colleagues'2 experience in transplanting lobes from living donors but assumed that this procedure was only applicable to children or small adults. To date, Starnes et al have transplanted bilateral lower lobes from living related donors into 24 adult patients with cystic fibrosis (mean age, 25.5 years; age range, 18 to 36 years). (An additional patient, aged 32


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