2018 年 53 巻 2-3 号 p. 133-138
【Objective】 To scrutinize the status of lung transplantation in Japan, the Japanese Society of Lung and Heart-Lung Transplantation started to collect and present registry data from 2005. This is the 14th official registry report of Japanese lung transplantation.
【Design and Methods】 The data on cadaveric lung transplantation and living-donor lobar lung transplantation performed by the end of 2017 were registered in the database and analyzed with respect to the number of transplants, recipient survival rates, recipient functional and working statuses, and causes of death after transplantations. Survival rates were calculated by the Kaplan-Meier method.
【Results】 A total of 388 cadaveric lung transplantation (201 single, 187 bilateral), 208 living-donor lobar lung transplantation and 3 heart-lung transplantation procedures were performed by the end of 2017. Five-year and 10-year survival rates of cadaveric lung transplantations were 71.7% and 55.7%, which were superior to those in the International Registry. Five-year and 10-year survival rates of living-donor lobar transplantations were similar to those of cadaveric lung transplantations with 73.4% and 64.1%. The recipients of the 3 heart-lung transplantations are alive. The functional status of more than 80% of recipients was restored to a mMRC scale of grade 0 or 1 after transplantation. Infection has been the leading cause of death after lung transplantation. Chronic lung allograft dysfunction and primary graft dysfunction accounts for about 17% of the causes of death after cadaveric and living-donor lung transplantation.
【Conclusion】 The outcomes of Japanese lung transplantation are so far satisfactory. Efforts must be made, however, to overcome early deaths resulting from primary graft dysfunctions and chronic lung allograft dysfunction. The modified Japanese transplantation law has been enforced since July 2010, and an increase in the number of cadaveric organ transplantations was achieved thereafter. The Japanese Society of Lung and Heart-Lung Transplantation will continue to present annual reports of Japanese lung transplantations.
