Abstract
Three-dimensional computed tomography (3D-CT) technologies have been developed and, recently, high-speed and high-quality 3D-CT technologies have been introduced to the field of thoracic surgery. The purpose of this manuscript is to demonstrate the clinical application of 3D-CT technologies in lung transplantation. In Japan, because of the severe donor shortage, living-donor lobar lung transplantation (LDLLT) is essential, in addition to cadaveric lung transplantation. In LDLLT, size matching is a grave issue, since ideal size matching between donor and recipient is usually difficult because of the limited population of potential donor. Size matching using pulmonary function test results has been widely used as a gold standard, but anatomical size matching using 3D-CT volumetry data has also been utilized in LDLLT. In donor lobectomy, 3D-CT images provided a variety of information regarding anatomical variation of pulmonary vessels and bronchial trees preoperatively. These images ensure surgical quality and safety, and they also affect surgical procedures for the recipient. 3D-CT images are also utilized in various aspects of postoperative care, such as detection of chronic lung allograft dysfunction and clarification of its subtypes. Furthermore, preoperative 3D-CT simulation is useful in developing and performing a special surgical procedure, such as right-to-left inverted LDLLT. In conclusion, following the introduction of 3D-CT to the field of thoracic surgery, various 3D-CT images and their application to preoperative simulations have been introduced in lung transplantation. In the near future, this technique will become more prevalent, and frequent use by thoracic surgeons will be seen worldwide in daily practice.
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Hemminger BM, Molina PL, Egan TM, Detterbeck FC, Muller KE, Coffey CS, Lee JK. Assessment of real-yime 3D visualization for cardiothoracic diagnostic evaluation and surgery planning. J Digit Imaging. 2005;18:145–53.
Ikeda N, Yoshimura A, Hagiwara M, Akata S, Saji H. Three dimensional computed tomography lung modeling is useful in simulation and navigation of lung cancer surgery. Ann Thorac Cardiovasc Surg. 2013;19:1–5.
Chen-Yoshikawa TF, Date H. Update on three-dimensional image reconstruction for preoperative simulation in thoracic surgery. J Thorac Dis. 2016;8:S295-301.
Mochizuki K, Takatsuki M, Soyama A, Hidaka M, Obatake M, Eguchi S, et al. The usefulness of a high-speed 3D-image analysis system in pediatric living donor liver transplantation. Ann Transplant 2012;17:31–4.
Hagiwara M, Shimada Y, Kato Y, Nawa K, Makino Y, Furumoto H, et al. High-quality 3-dimensional image simulation for pulmonary lobectomy and segmentectomy: results of preoperative assessment of pulmonary vessels and short-term surgical outcomes in consecutive patients undergoing video-assisted thoracic surgery. Eur J Cardiothorac Surg. 2014;46:e120-6.
Date H, Sato M, Aoyama A, Yamada T, Mizota T, Kinoshita H, et al. Living-donor lobar lung transplantation provides similar survival to cadaveric lung transplantation even for sicker patients. Eur J Cardiothorac Surg 2015;47:967–72.
Chen F, Yamane M, Inoue M, Shiraishi T, Oto T, Minami M, et al. Less maintenance immunosuppression in lung transplantation following hematopoietic stem cell transplantation from the same living donor. Am J Transplant. 2011;11:1509–16.
Date H. Current status and problems of lung transplantation in Japan. J Thorac Dis. 2016;8:S631-6.
Starnes VA, Barr ML, Cohen RG, Hagen JA, Wells WJ, Horn MV, et al. Living-donor lobar lung transplantation experience: intermediate results. J Thorac Cardiovasc Surg. 1996;112:1284–91.
Date H, Aoe M, Nahagiho I, Sano Y, Andou A, Matsubara H, et al. Living-donor lobar lung transplantation for various lung diseases. J Heart Lung Transpl 2003;126:476–81.
Cohen RG, Barr ML, Schenkel FA, DeMeester TR, Wells WJ, Starnes VA. Living-related donor lobectomy for bilateral lobar transplantation in patients with cystic fibrosis. Ann Thorac Surg. 1994;57:1423–8.
Miyoshi R, Chen-Yoshikawa TF, Hijiya K, Motoyama H, Aoyama A, Menju T, et al. Significance of single lung transplantation in the current situation of severe donor shortage in Japan. Gen Thorac Cardiovasc Surg. 2016; 64:93–7.
Chen F, Kubo T, Yamada T, Sato M, Aoyama A, Bando T, et al. Adaptation over a wide range of donor graft lung size discrepancies in living-donor lobar lung transplantation. Am J Transplant. 2013;13:1336–42.
Aoyama A, Chen F, Minakata K, Yamzaki K, Yamada T, Sato M, et al. Sparing native upper lobes in living-donor lobar lung transplantation: Five cases from a single center. Am J Transplant. 2015;15:3202–7.
Fujinaga T, Bando T, Nakajima D, Sakamoto J, Chen F, Shoji T, et al. Living-donor lobar lung transplantation with sparing of bilateral native upper lobes: a novel strategy. J Heart Lung Transplant. 2011;30:351–3.
Chen F, Fujinaga T, Bando T, Date H. Pulmonary function of individual lung lobes after complex living-donor lobar lung transplantation using inspiratory and expiratory three-dimensional computed tomographic volumetry. Interact Cardiovasc Thorac Surg. 2012;15:1077–9.
Date H, Aoe M, Nagahiro I, Sano Y, Matsubara H, Goto K, et al. How to predict forced vital capacity after living-donor lobar-lung transplantation. J Heart Lung Transplant. 2004;23:547–51.
Kojima K, Kato K, Oto T, Mitsuhashi T, Shinya T, Sei T, et al. Preoperative graft volume assessment with 3D-CT volumetry in living-donor lobar lung transplantations. Acta Med Okayama. 2011;65:265–8.
Chen F, Fujinaga T, Shoji T, Yamada T, Nakajima D, Sakamoto J, et al. Perioperative assessment of oversized lobar graft downsizing in living-donor lobar lung transplantation using three-dimensional computed tomographic volumetry. Transpl Int. 2010;23:e41-4.
Shiraishi T, Hiratsuka M, Munakata M, Higuchi T, Makihata S, Yoshinaga Y, et al. Living-donor single-lobe lung transplantation for bronchiolitis obliterans in a 4-year-old boy. J Thorac Cardiovasc Surg. 2007;134:1092–3.
Camargo JJP, Irion KL, Marchiori E, Hochhegger B, Porto NS, Moraes BG, et al. Computed tomography measurement of lung volume in preoperative assessment for living donor lung transplantation: Volume calculation using 3D surface rendering in the determination of size compatibility. Pediatr Transpl. 2009;13:429–39.
Hiroshige S, Shimada M, Harada N, Shiotani S, Ninomiya M, Minagawa R, et al. Accurate preoperative estimation of liver-graft volumetry using three-dimensional computed tomography. Transplantation. 2003;75:1561–4.
Ueda K, Tanaka T, Hayashi M, Li TS, Tanaka N, Hamano K. Computed tomography-defined functional lung volume after segmentectomy versus lobectomy. Eur J Cardiothorac Surg. 2010;37:1433–7.
Takahashi K, Chen F, Ikeda T, Doi H, Nakamura H, Yanagi S, et al. Single-lobe lung transplantation for rapidly deteriorating pulmonary veno-occlusive disease. Ann Thorac Surg 2013;95:689–91.
Duong PT, Ferson PF, Fuhrman CR, McCurry KR, Lacomis JM. 3D-multidetector CT angiography in the evaluation of potential donors forliving donor lung transplantation. J Thorac Imaging. 2005;20:17–23.
Chen F, Fujinaga T, Shoji T, Kubo T, Sonobe M, Sato M, et al. Short-term outcome in living donors for lung transplantation: the role of preoperative computer tomographic evaluations of fissures and vascular anatomy. Transpl Int. 2012;25:732–8.
Chen F, Fujinaga T, Shoji T, Sonobe M, Sato T, Sakai H, et al. Outcomes and pulmonary function in living lobar lung transplant donors. Transpl Int. 2012;25:153–7.
Chen F, Yamada T, Sato M, Aoyama A, Takahagi A, Menju T, et al. Postoperative pulmonary function and complications in living-donor lobectomy. J Heart Lung Transpl. 2015;34:1089–94.
Kayawake H, Chen-Yoshikawa TF, Aoyama A, Motoyama H, Hijiya K, Menju T, et al. Excellent outcome of donor lobectomy with various surgical techniques for the interlobar artery. Eur J Cardiothorac Surg. 2017;51:279–83.
Barr ML, Belghiti J, Villamil FG, Pomfret EA, Sutherland DS, Gruessner RW, et al. A report of the Vancouver Forum on the care of the live organ donor: lung, liver, pancreas, and intestine data and medical guidelines. Transplantation. 2006;81:1373–85.
Chen F, Miwa S, Bando T, Date H. Pulmonary arterioplasty for the remaining arterial stump of the donor and the arterial cuff of the donor graft in living-donor lobar lung transplantation. Eur J Cardiothorac Surg. 2012;42:e138-9.
Yusen RD, Edwards LB, Dipchand AI, Goldfarb S, Kucheryavaya AY, Levvey Rn BJ, et al. The registry of the International Society for Heart and Lung Transplantation: thirty-third adult lung and heart-lung transplant report-2016: focus theme: primary diagnostic indications for transplant. J Heart Lung Transplant. 2016;35:1170–84.
Motoyama H, Chen F, Ohsumi A, Hijiya K, Takahashi M, Ohata K, et al. Quantitative evaluation of native lung hyperinflation after single lung transplantation for emphysema using three-dimensional computed tomography volumetry. Transpl Proc. 2014;46:941–3.
Verleden GM, Raghu C, MeyerKC, Glanville AR, Corris P. A new classification system for chronic lung allograft dysfunction. J Heart Lung Transpl 2014; 33: 127 – 33.
Shinya T, Sato S, Kato K, Gobara H, Akaki S, Date H, et al. Assessment of mean transit time in the engrafted lung with 133Xe lung ventilation scintigraphy improves diagnosis of bronchiolitis obliterans syndrome in living-donor lobar lung transplant recipients. Ann Nucl Med 2008;22:31–9.
Miyamoto E, Chen F, Aoyama A, Sato M, Yamada T, Date H. Unilateral chronic lung allograft dysfunction is a characteristic of bilateral living-donor lobar lung transplantation. Eur J Cardiothorac Surg. 2015;48:463–9.
Saito T, Horie M, Sato M, Nakajima D, Shoushtarizadeh H, Binnie M, et al. Low-dose computed tomography volumetry for subtyping chronic lung allograft dysfunction. J Heart Lung Transpl. 2016;35:59–66.
Dettmer S, Shin HO, Vogel-Claussen J, Westphal M, Haverich A, Warnecke G, et al. CT at onset of chronic lung allograft dysfunction in lung transplant patients predicts development of the restrictive phenotype and survival. Eur J Radiol. 2017
Kneidinger N, Milger K, Janitza S, Ceelen F, Leuschner G, Dinkel J, et al. Lung volumes predict survival in patients with chronic lung allograft dysfunction. Eur Respir J. 2017;49:1601315.
Miyamoto E, Chen-Yoshikawa TF, Higuchi H, Aoyama A, Date H. Stenosis of the segmental bronchus is a characteristic airway complication in living-donor lobar lung transplantation. J Heart Lung Transpl 2016;35:389–92.
Chen F, Miyamoto E, Takemoto M, Minakata K, Yamada T, Sato M, et al. Right left inverted lobar lung transplantation. Am J Transpl. 2015;15:1716–21.
Hata A, Nakajima T, Yoshida S, Kinoshita T, Terada J, Tatsumi K,et al. Living donor lung transplantation for pleuroparenchymal fibroelastosis. Ann Thorac Surg. 2016;101:1970–2.
Oto T, Miyoshi K, Sugimoto S, Yamane M. Living related donor middle lobe lung transplant in a pediatric patient. J Thorac Cardiovasc Surg. 2015;149:e42-4.
Schertler T, Lardinois D, Boehm T, Weder W, Wildermuth S, Alkadhi H. Lung transplantation in Kartagenersyndrome and situs inversus: potential of multidetector row computed tomography and three-dimensional postprocessing. J Thorac Cardiovasc Surg. 2007;134:814–5.
Konheim JA, Kon ZN, Pasrija C, Luo Q, Sanchez PG, Garcia JP, et al. Predictive equations for lung volumes from computed tomography for size matching in pulmonary transplantation. J Thorac Cardiovasc Surg. 2016;15:1163–9.
Chen F, Kubo T, Shoji T, Fujinaga Bando T, Date H. Comparison of pulmonary function test and computed tomography volumetry in living lung donors. J Heart Lung Transpl. 2011;30:572–5.
Mizobuchi T, Chen F, Yoshino I, Iwata T, Yoshida S, Bando T, et al. Radiologic evaluation for volume and weight of remnant lung in living lung donors. J Thorac Cardiovasc Surg. 2013;146:1253–8.
Mizobuchi T, Wada H, Sakairi Y, Suzuki H, Nakajima T, Tagawa T, et al. Spirometric and radiological evaluation of the remnant lung long after major pulmonary resection: can compensatory phenomena be recognized in clinical cases? Surg Today. 2014;44:1735–43.
Butler JP, Loring SH, Patz S, Tsuda A, Yablonskiy DA, Mentzer SJ. Evidence for adult lung growth in humans. N Engl J Med. 2012;367:244–7.
Miyoshi R, Chen-Yoshikawa TF, Takahagi A, Oshima Y, Hijiya K, Motoyama H, et al. Pulmonary function and exercise capacity in patients with flat chests after lung transplantation. Ann Thorac Surg. (Accepted).
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Chen-Yoshikawa, T.F., Date, H. Three-dimensional image in lung transplantation. Gen Thorac Cardiovasc Surg 66, 19–26 (2018). https://doi.org/10.1007/s11748-017-0849-y
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DOI: https://doi.org/10.1007/s11748-017-0849-y