ArticleTransplant international : official journal of the European Society for Organ Transplantation2026
Undersized lung grafts in chronic obstructive pulmonary disease transplant recipients: risk factor or acceptable compromise?
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Size matching is an important concern during lung allocation for lung transplantation (LTx). Although some mismatch is accepted-often favoring larger grafts for patients with chronic obstructive pulmonary disease (COPD)-the optimal strategy remains unclear. This study evaluated the impact of graft size mismatch on postoperative outcomes in COPD. We retrospectively reviewed 130 of 491 patients who underwent LTx at a single center between January 2013 and December 2023. Patients were classified into three groups based on donor-to-recipient predicted total lung capacity ratio: undersized (<0.9), size-matched (0.9-1.1), and oversized (≥1.1). Donor and recipient characteristics were collected. Primary graft dysfunction (PGD) was the primary endpoint; overall survival was secondary. Of the 130 patients, 17 (13%) received undersized grafts, 67 (52%) size-matched grafts, and 46 (35%) oversized grafts. The undersized group had a lower incidence of PGD at 48 and 72 h than other groups (
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