ABSTRACT
Purpose The uniqueness and immunological complexity, makes double lung transplantation a challenging high end surgical management for end stage lung disease. Finding the ideal donor organ offers a multitude of logistical barriers., and when that happens, a size mismatch should never be an excuse to waddle the opportunity. The objective of this retrospective review was to observe the clinical outcomes of double lung transplant recipients who underwent non anatomical pulmonary resections. Methods Our team had done 67 double lung transplantations in 2019 and 20 double lung transplants in 2020. A significant reduction by volume was possibly because of lesser donor organ availability in a covid inflicted scenario,thereby creating greater momentum to salvage every donor organ available. A total of sixteen recipients (11 in 2019, 5 in 2020)had undergone size reduction to accomodate oversized lungs. We reviewed the data (case series) of all the sixteen patients who had undergone non anatomical pulmonary resections prior to primary chest closure. Results Out of the 87 double lung transplantation recipients, 16 recipients had to undergo size reduction, 10 recipients underwent resections isolated to right lung, the segments resected were the anterior part of middle lobe, and lower lobe basal and posterior segments.6 patients had both right and left lung resections, the lingulae being the resected segment . Linear endovascular stapples were used for resection, enhanced with bovine pericardium or donor pericardium. Fifteen of the recipients had no post-operative air leak, one had trivial air leak that settled with conservative management and did not require an additional intercostal drainage. Conclusion With good prerequisites, non anatomical resection in an oversized donor organ does not add to the morbidity in the short follow up.