Hirama Takashi, Okada Yoshinori
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Division of Organ Transplantation, Tohoku University Hospital, Sendai, Miyagi, Japan.
J Thorac Dis. 2023 Sep 28;15(9):5174-5181. doi: 10.21037/jtd-22-1716. Epub 2023 Jul 10.
Lung transplantation (LTx) in Japan has taken steps toward increasing the number of donors and recipients and is at the maturity stage of development, at which point pulmonologists (hereinafter referred to as "respirologists") become involved in transplant practice. Because of severe donor shortage and limited number of LTx surgeries, most of transplant process from candidacy evaluation to post-operative management has been handled only by thoracic surgeons, which takes away opportunities from respirologists to manage LTx recipients. Given the growth of both LTx and the number of patients with complex problems, cooperation with respirologists in transplant practice is urgently needed to achieve transplant success in Japan.
Authors summarized current transplant circumstance in Japan from the transplant physician's standpoint. A systematic search through PubMed database and Google Scholar was performed by terms of "respirologists", "pulmonologist", "lung transplant" or "Japan" from 2000 and 2022. Thoracic surgeons working at each transplant center were asked to complete a questionnaire on physicians' intervention to LTx.
The roles of respirologists in LTx differ with facility size and function, depending on whether they are working at a non-transplant center with other respirologists or at a transplant center with transplant physicians. LTx centers are currently devoted to educating respirologists who work at non-transplant or low-volume transplant centers in order for them to deal with patients before and after transplantation.
Joint efforts and training of outstanding personnel who can take care of recipients are required, this being the greatest issue for the success of transplantation in Japan.
日本的肺移植（LTx）已在增加供体和受体数量方面取得进展，处于发展的成熟阶段，此时肺科医生（以下简称“呼吸科医生”）开始参与移植实践。由于供体严重短缺以及肺移植手术数量有限，从候选评估到术后管理的大部分移植过程一直仅由胸外科医生处理，这使得呼吸科医生失去了管理肺移植受者的机会。鉴于肺移植及复杂问题患者数量的增长，在日本迫切需要呼吸科医生在移植实践中的合作以实现移植成功。
作者从移植医生的角度总结了日本当前的移植情况。通过在PubMed数据库和谷歌学术上以“呼吸科医生”“肺科医生”“肺移植”或“日本”为关键词，对2000年至2022年期间的文献进行了系统检索。要求各移植中心的胸外科医生填写一份关于医生对肺移植干预情况的问卷。
呼吸科医生在肺移植中的作用因机构规模和功能而异，这取决于他们是在有其他呼吸科医生的非移植中心工作，还是在有移植医生的移植中心工作。肺移植中心目前致力于培训在非移植或低容量移植中心工作的呼吸科医生，以便他们能够处理移植前后的患者。
需要共同努力并培养能够照顾受者的优秀人才，这是日本移植成功的最大问题。
