2024 World Conference on Lung Cancer (WCLC) - Posters-P1.09B.03 Ex-Situ Lung Transplantation without Heparinization: A Novel Surgical Approach for Locally Advanced and Central Lung Carcinoma

P1.09B.03 Ex-Situ Lung Transplantation without Heparinization: A Novel Surgical Approach for Locally Advanced and Central Lung Carcinoma

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The document presents a novel approach for ex-situ lung transplantation in patients with locally advanced central lung carcinoma, focusing on performing the procedure without heparinization. Traditionally, such surgeries incorporate heparinization; however, this study explores an alternative method, illustrating that cardiopulmonary bypass and heparin may not be needed, which potentially simplifies the surgical process and reduces associated risks.<br /><br />The study involved four patients, all with a median age of 69 years, who received neoadjuvant treatment before surgery. The procedures were meticulously pre-planned using CT imaging to ensure successful transplantation. Vascular anastomosis was confirmed via pulmonary artery CT angiography. Only one patient experienced a non-fatal partial branch embolism of the contralateral pulmonary artery, suggesting the feasibility of omitting intraoperative heparinization in certain cases.<br /><br />Postoperative outcomes at a three-month follow-up indicated that all patients were asymptomatic, demonstrating favorable initial results. The surgical procedure involved several key steps, including the fifth intercostal lateral thoracotomy, pulmonary hilum dissection, ex-vivo lesion resection, lung perfusion with Perfedex, and careful anastomosis using different prolene sutures.<br /><br />The document suggests that ex-situ lung transplantation, without the use of heparinization, could be a promising alternative to pneumonectomy for patients with central lung cancer. However, it emphasizes the necessity of long-term follow-up and survival analysis to validate these findings further. Overall, this study contributes to the potential enhancement of surgical options available for treating complex lung cancer cases, offering a more streamlined and potentially safer approach.

Asset Subtitle

Sijia Yang

Meta Tag

Speaker Sijia Yang

Topic Metastatic NSCLC – Local Therapies

Keywords

ex-situ lung transplantation

central lung carcinoma

heparinization

cardiopulmonary bypass

neoadjuvant treatment

CT imaging

vascular anastomosis

pulmonary artery CT angiography

lung perfusion

pneumonectomy alternative