Long-term follow-up after living-donor lung transplantation for bronchiolitis obliterans in a patient who received unrelated bone marrow transplantation

Abstract

Lung transplantation is the only curative therapy for refractory bronchiolitis obliterans (BO) after hematopoietic stem cell transplantation. In cases of lung transplantation in growing children, the adaptation of lung allografts to substantial somatic growth changes has been a concern, in addition to complications such as rejection and infections. A 10-year-old boy who suffered from acute myeloid leukemia developed BO after unrelated bone marrow transplantation, and received a living-donor lung transplant from his parents. He had complications of chronic rejection, cytomegalovirus infection, and renal dysfunction, which were all treated successfully. His quality of life improved dramatically, and he now lives an almost normal life. Both height catch-up and adequate growth of bilateral lungs were achieved seven and a half years after lung transplantation. Careful long-term follow-up should be performed by not only thoracic surgeons and pediatric hematologists but also various medical specialists such as pediatric endocrinologists, nephrologists, and neurologists.