start-ver=1.4
cd-journal=joma
no-vol=15
cd-vols=
no-issue=9
article-no=
start-page=5182
end-page=5194
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2023
dt-pub=20230627
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Long-term management and outcome of lung transplantation in Japan
en-subtitle=
kn-subtitle=
en-abstract=
kn-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.
en-copyright=
kn-copyright=

en-aut-name=SugimotoSeiichiro
en-aut-sei=Sugimoto
en-aut-mei=Seiichiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=

en-aut-name=MatsubaraKei
en-aut-sei=Matsubara
en-aut-mei=Kei
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=

en-aut-name=TanakaShin
en-aut-sei=Tanaka
en-aut-mei=Shin
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=

en-aut-name=MiyoshiKentaroh
en-aut-sei=Miyoshi
en-aut-mei=Kentaroh
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=

en-aut-name=IshiharaMegumi
en-aut-sei=Ishihara
en-aut-mei=Megumi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=

en-aut-name=ToyookaShinichi
en-aut-sei=Toyooka
en-aut-mei=Shinichi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=

affil-num=1
en-affil=Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
kn-affil=

affil-num=2
en-affil=Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
kn-affil=

affil-num=3
en-affil=Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
kn-affil=

affil-num=4
en-affil=Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
kn-affil=

affil-num=5
en-affil=Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
kn-affil=

affil-num=6
en-affil=Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital
kn-affil=
en-keyword=Lung transplantation
kn-keyword=Lung transplantation
en-keyword=chronic lung allograft dysfunction
kn-keyword=chronic lung allograft dysfunction
en-keyword=infection
kn-keyword=infection
en-keyword=malignan
kn-keyword=malignan
en-keyword=cychronic kidney
kn-keyword=cychronic kidney
en-keyword=disease
kn-keyword=disease
END