title: Less maintenance immunosuppression in lung transplantation following hematopoietic stem cell transplantation from the same living donor.
abstract: Living-donor lobar lung transplantation (LDLLT) is one of the final options for saving patients with pulmonary complications after hematopoietic stem cell transplantation (HSCT). We retrospectively investigated 19 patients who had undergone LDLLT after HSCT in Japan. Eight patients underwent LDLLT after HSCT in which one of the donors was the same living donor as in HSCT (SD group), while 11 received LDLLT from relatives who were not the HSCT donors (non-SD group). In the SD group, three patients underwent single LDLLT. The 5-year survival rate was 100% and 58% in the SD and non-SD groups, respectively. In the SD group, postoperative immunosuppression was significantly lower than in the non-SD group. Two patients died of infection and one died of post-transplant lymphoproliferative disease (PTLD) in the non-SD group, while only one patient died of PTLD 7 years after LDLLT in the SD group. Hematologic malignancy relapsed in two patients in the non-SD group. For the three single LDLLTs in the SD group, immunosuppression was carefully tapered. In our study, LDLLT involving the same donor as for HSCT appeared to have advantages related to lower immunosuppression compared to LDLLT from relatives who were not the HSCT donors.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. hdate@kuhp.kyoto-u.ac.jp
authors.forename: F
authors.initials: F
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Yamane
authors.forename: M
authors.initials: M
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Shiraishi
authors.forename: T
authors.initials: T
authors.lastname: Oto
authors.forename: M
authors.initials: M
authors.lastname: Minami
authors.forename: J
authors.initials: J
authors.lastname: Yanagisawa
authors.forename: T
authors.initials: T
authors.lastname: Fujinaga
authors.forename: T
authors.initials: T
authors.lastname: Shoji
authors.forename: S
authors.initials: S
authors.lastname: Toyooka
authors.forename: M
authors.initials: M
authors.lastname: Okumura
authors.forename: S
authors.initials: S
authors.lastname: Miyoshi
authors.forename: T
authors.initials: T
authors.lastname: Bando
authors.forename: H
authors.initials: H
authors.lastname: Date
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007564:Japan; D019520:Living Donors; D016040:Lung Transplantation; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome