Immunosuppression and Long-term Survival After Single Living-donor Lobar Lung Transplantation From the Same Donor as Prior Hematopoietic Stem Cell Transplantation: An All-Japan Study.
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Abstract
Background: Single living-donor lobar lung transplantation (LDLLT) from the same donor as prior hematopoietic stem cell transplantation (HSCT) represents a unique immunologic setting because of donor-cell chimerism. However, data regarding immunosuppressive management and long-term outcomes in this setting remain limited.
Methods: We conducted a retrospective multicenter observational study of all patients in Japan who underwent single LDLLT from the same donor as in their prior HSCT. Between November 2006 and December 2024, 9 patients underwent this procedure at 5 centers.
Results: All recipients received immunosuppressive therapy for at least 3 mo after LDLLT. During follow-up, immunosuppression was successfully discontinued in 3 patients, whereas the remaining 6 were maintained on individualized reduced-dose maintenance immunosuppression. One patient died 39 mo after LDLLT, with respiratory dysfunction presumed to be associated with severe malnutrition. At a median follow-up of 154 mo for the entire cohort, 8 patients were alive with acceptable graft function.
Conclusions: In this highly selected case series, acceptable long-term survival was observed after single LDLLT from the same donor as prior HSCT under reduced immunosuppression, and immunosuppression was successfully withdrawn in 3 patients.
期刊介绍：
The official journal of The Transplantation Society, and the International Liver Transplantation Society, Transplantation is published monthly and is the most cited and influential journal in the field, with more than 25,000 citations per year.
Transplantation has been the trusted source for extensive and timely coverage of the most important advances in transplantation for over 50 years. The Editors and Editorial Board are an international group of research and clinical leaders that includes many pioneers of the field, representing a diverse range of areas of expertise. This capable editorial team provides thoughtful and thorough peer review, and delivers rapid, careful and insightful editorial evaluation of all manuscripts submitted to the journal.
Transplantation is committed to rapid review and publication. The journal remains competitive with a time to first decision of fewer than 21 days. Transplantation was the first in the field to offer CME credit to its peer reviewers for reviews completed.
The journal publishes original research articles in original clinical science and original basic science. Short reports bring attention to research at the forefront of the field. Other areas covered include cell therapy and islet transplantation, immunobiology and genomics, and xenotransplantation.
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