Sugimoto Seiichiro, Tanaka Shin, Miyoshi Kentaroh, Toyooka Shinichi
Organ Transplant Center and General Thoracic Surgery, Okayama University Hospital, Okayama, Japan.
Kyobu Geka. 2022 Apr;75(4):297-301.
Long-term survival after living-donor lobar lung transplantation (LDLLT) is hampered by the development of chronic lung allograft dysfunction( CLAD), similar to the clinical courses seen in some recipients of cadaveric lung transplantation( CLT). CLAD after bilateral LDLLT has been shown to be characterized by the development in the unilateral lung due to differences in the immunological features of the two donors. Based on this characteristic, we found that lung perfusion scintigraphy, which can show a perfusion shift to the contralateral unaffected lung with the development of CLAD, had the potential to predict unilateral CLAD after bilateral LDLLT. Moreover, we found that CLAD, especially restrictive allograft syndrome, developed significantly later after bilateral LDLLT than after bilateral CLT, although the CLAD-free survival and overall survival after bilateral LDLLT were similar to those after bilateral CLT. We describe our experience of CLAD after bilateral LDLLT since the first case of LDLLT in Japan.
与一些尸体肺移植（CLT）受者的临床病程相似，活体供者肺叶移植（LDLLT）后的长期生存受到慢性肺移植功能障碍（CLAD）发展的阻碍。双侧LDLLT后的CLAD表现为单侧肺的病变，这是由于两个供者免疫特征的差异所致。基于这一特点，我们发现肺灌注闪烁扫描能够显示随着CLAD的发展，灌注向对侧未受影响的肺转移，它有可能预测双侧LDLLT后的单侧CLAD。此外，我们发现，双侧LDLLT后的CLAD，尤其是限制性移植综合征，比双侧CLT后的发生时间显著延迟，尽管双侧LDLLT后的无CLAD生存期和总生存期与双侧CLT后的相似。我们描述了自日本首例LDLLT以来双侧LDLLT后CLAD的经验。
