TY - JOUR
T1 - Less maintenance immunosuppression in lung transplantation following hematopoietic stem cell transplantation from the same living donor
AU - Chen, F.
AU - Yamane, M.
AU - Inoue, M.
AU - Shiraishi, T.
AU - Oto, Takahiro
AU - Minami, M.
AU - Yanagisawa, J.
AU - Fujinaga, T.
AU - Shoji, T.
AU - Toyooka, S.
AU - Okumura, M.
AU - Miyoshi, Shinichiro
AU - Bando, T.
AU - Date, H.
PY - 2011/7
Y1 - 2011/7
N2 - 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. Living-donor lobar lung transplantation involving the same donor as for hematopoietic stem cell transplantation appears to have advantages related to lower immunosuppression compared to living-donor lobar lung transplantation from relatives who are not the hematopoietic stem cell transplantation donors.
AB - 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. Living-donor lobar lung transplantation involving the same donor as for hematopoietic stem cell transplantation appears to have advantages related to lower immunosuppression compared to living-donor lobar lung transplantation from relatives who are not the hematopoietic stem cell transplantation donors.
KW - Hematopoietic stem cell transplantation
KW - living-donor lobar lung transplantation
KW - lung transplantation
KW - same donor
UR - http://www.scopus.com/inward/record.url?scp=79959856311&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79959856311&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2011.03591.x
DO - 10.1111/j.1600-6143.2011.03591.x
M3 - Article
C2 - 21672149
AN - SCOPUS:79959856311
SN - 1600-6135
VL - 11
SP - 1509
EP - 1516
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 7
ER -