-- Robert Preidt
THURSDAY, Aug. 1 (HealthDay News) -- Bigger might be better when
it comes to lung transplants, a new study says.
Researchers found that lung transplant recipients who received
bigger lungs were more likely to survive than those who received
smaller lungs. This was particularly true among those who received
"An unresolved question in the field of lung transplantation is how the size of the donor lungs relative to the recipient affects transplant success. It is commonly believed that transplanting oversized lungs is problematic, but no data were available to substantiate that idea," study author Michael Eberlein, a clinical assistant professor in internal medicine at the University of Iowa, said in a university news release.
He and his colleagues analyzed data from nearly 7,000 patients
who underwent either single-lung or double-lung transplants in the
United States between May 2005 and April 2010. In the United
States, height is used to determine lung size for transplant
But for this study, the researchers developed and used a formula
called predicted total lung capacity (pTLC) ratio. A person's
predicted total lung capacity is calculated using height and
gender. Taller people have bigger lungs, and a man's lungs are
larger than those of a woman of the same height, the study authors
The predicted total lung capacity ratio is arrived at by
dividing the donor's predicted total lung capacity by the patient's
predicted total lung capacity. A ratio of 1.0 is a perfect size
match, while a ratio of 1.3 indicates that the donor lung is
significantly larger than the recipient's lung.
Among patients who had a double-lung transplant, each 0.1
increase in the predicted total lung capacity ratio was associated
with a 7 percent decrease in risk of death a year after the
procedure. Among those who had a single-lung transplant, each 0.1
increase in predicted total lung capacity ratio was associated with
a 6 percent decrease in the risk of death a year later.
"This study shows that lung size matters in lung-transplant procedures," Eberlein said. "We found that oversized (lungs), up to a point, were associated with improved survival after lung transplantation. We would hope that recipients, within surgically feasible limits, could be listed for higher donor height ranges and ultimately have a better chance of receiving an acceptable donor lung."
The study was published Aug. 1 in the
Annals of Thoracic Surgery.
Seth Force, of Emory University School of Medicine in Atlanta,
commented on the study's strength in an accompanying journal
editorial. "The data in this manuscript make a compelling argument
for the lung transplant community, as well as (United Network for
Organ Sharing), to consider changing to a pTLC method for lung
sizing for listed patients," Force concluded.
The U.S. National Heart, Lung, and Blood Institute has more
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