【Objective】 This paper presents the 20th official registry report on lung transplantation in Japan, conducted by the Japanese Society of Lung and Heart-Lung Transplantation since 2005.
【Design and Methods】 The study analyzed data from cadaveric lung transplantation, living-donor lung transplantation, and heart-lung transplantation performed until the end of 2023. The data included transplant numbers, recipient survival rates, functional and working statuses, and causes of death. Survival rates were calculated using the Kaplan-Meier method.
【Results】 By the end of 2023, a total of 871 cadaveric lung transplantations (438 single, 433 bilateral), 293 living-donor lung transplantations, and 3 heart-lung transplantations were performed. The number of cadaveric lung transplants reached a record high of 128 in 2023. The 5-year and 10-year survival rates for cadaveric lung transplantations were 73.52% and 60.32%, respectively, surpassing international registry data. The survival rates for living-donor transplantations were similar to those of cadaveric lung transplantation, with 5-year and 10-year rates of 73.36% and 60.52%, respectively. All three heart-lung transplant recipients are alive. 75.9% of cadaveric lung transplant recipients achieved an mMRC scale grade of 0 or 1, as did 75.2% of living-donor lung transplant recipients. Infections were the leading cause of death after lung transplantation in both cadaveric and living-donor lung transplantation. Primary graft dysfunction, which used to be a serious problem after lung transplantation, has become less frequent.
【Conclusion】 The outcomes of lung transplantation in Japan have been satisfactory. Although the number of transplants decreased in 2020 due to the COVID-19 pandemic, it recovered in 2021 and reached a record high in 2022 and again in 2023. The Japanese Society of Lung and Heart-Lung Transplantation will continue to provide annual reports on Japanese lung transplantations.
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