ID | 65705 |
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Author |
Sugimoto, Seiichiro
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
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Matsubara, Kei
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
Tanaka, Shin
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
Miyoshi, Kentaroh
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
Kaken ID
Ishihara, Megumi
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
Toyooka, Shinichi
Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
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Abstract | The long-term survival after lung transplantation (LT) is favorable in Japan. However, longterm survivors after LT are subject to late complications, including chronic lung allograft dysfunction (CLAD), malignancy, infection, and chronic kidney disease (CKD) because of the need for lifelong immunosuppression. The rates of single cadaveric LT (CLT) and living-donor lobar LT (LDLLT) are higher than that of bilateral CLT in Japan. Here, we will describe the management of late complications and long-term outcome after LT in Japan. Attention should be paid to not only the phenotype of CLAD but also the difference in CLAD after CLT and after LDLLT as well as the timing of lung re-transplantation for advanced CLAD, especially after single CLT. Since post-transplant lymphoproliferative disorder is the most common malignancy after LT, infection monitoring for infection-related malignancies and appropriate screening are keys to the early diagnosis and treatment of malignancy after LT. The long-term management of infection after LT is also important, especially with regard to community-acquired pathogens, Aspergillus, and cytomegalovirus. When providing long-term care after LT, physicians should be aware of CKD and the timing of renal replacement therapy in cases with severe CKD. The widespread use of computed tomography and dialysis in Japan are beneficial for long-term survivors of LT. The similar survival outcomes of single CLT and LDLLT, compared with bilateral CLT, might contribute to improved long-term survival in Japan. Pulmonologists are encouraged to become further involved in long-term management after LT in Japan.
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Keywords | Lung transplantation
chronic lung allograft dysfunction
infection
malignan
cychronic kidney
disease
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Published Date | 2023-06-27
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Publication Title |
Journal of Thoracic Disease
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Volume | volume15
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Issue | issue9
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Publisher | AME Publishing Company
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Start Page | 5182
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End Page | 5194
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ISSN | 2072-1439
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © Journal of Thoracic Disease.
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File Version | publisher
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Related Url | isVersionOf https://doi.org/10.21037/jtd-22-1679
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License | https://creativecommons.org/licenses/by-nc-nd/4.0/
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Citation | Sugimoto S, Matsubara K, Tanaka S, Miyoshi K, Ishihara M, Toyooka S. Long-term management and outcome of lung transplantation in Japan. J Thorac Dis 2023;15(9):5182-5194. doi: 10.21037/jtd-22-1679
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