J.Jpn. Surg. Soc.. 121(2): 164-168, 2020

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Feature topic

LUNG TRANSPLANTATION

Lung transplantation has been established as an effective treatment for end-stage lung disease since its first success in 1983. Today, more than 4,500 surgeries are performed annually and the cumulative number of cases worldwide is approximately 65,000 for adult lung transplants alone. In Japan, the first living-donor lobar lung transplantation and the first cadaveric lung transplantation were performed in 1998 and 2000, respectively. By the end of 2018, 447 cadaveric lung transplants (231 single and 216 bilateral) and 221 living-donor lobar lung transplants (34 unilateral and 187 bilateral) had been registered in the Japanese Lung Transplant Registry. The main indications for lung transplantation are idiopathic interstitial pneumonia, chronic obstructive pulmonary disease, and cystic fibrosis in the international registry and idiopathic interstitial pneumonia, pulmonary arterial hypertension, and lymphangioleiomyomatosis in the Japanese registry. The 5-year survival rate in the international registry is 55％, while the 5-year survival rates of cadaveric and living-donor lung transplantation in Japan are 72％ and 74％, respectively. The main causes of death after lung transplantation consist of primary graft dysfunction in the acute phase and bronchiolitis obliterans syndrome in the chronic phase, and establishment of preventive/treatment modalities for these complications is particularly important for further improvement in the outcomes of lung transplant recipients.

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