2019 年 54 巻 2-3 号 p. 105-110
【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 15th official registry report of Japanese lung transplantation.
【Design and Methods】 The data of cadaveric lung transplantation and living-donor lobar lung transplantation performed by the end of 2018 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 transplantation. Survival rates were calculated by the Kaplan-Meier method.
【Results】 A total of 447 cadaveric lung transplantation (231 single, 216 bilateral), 221 living-donor lobar lung transplantation and 3 heart-lung transplantation procedures were performed by the end of 2018. Five-year and 10-year survival rates for cadaveric lung transplantations were 71.9% and 57.8%, which were superior to those in the International Registry. Five-year and 10-year survival rates for living-donor lobar transplantations were similar to those for cadaveric lung transplantation at 74.0% and 63.3%. The recipients of 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 transplantations. Infection has been the leading cause of death after lung transplantation. Chronic lung allograft dysfunction and primary graft dysfunction account for about 18% of the causes of death after cadaveric and living-donor lung transplantations.
【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 has been achieved thereafter. The Japanese Society of Lung and Heart-Lung Transplantation will continue to present annual reports of Japanese lung transplantations.
