TY - JOUR
T1 - Living-donor lobar lung transplantation for pulmonary complications after hematopoietic stem cell transplantation
AU - Yamane, Masaomi
AU - Sano, Yoshifumi
AU - Toyooka, Shinichi
AU - Okazaki, Megumi
AU - Date, Hiroshi
AU - Oto, Takahiro
N1 - Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2008/12/27
Y1 - 2008/12/27
N2 - BACKGROUND.: The indication of lung transplantation for patients with pulmonary complications of hematopoietic stem cell transplantation (HSCT) remains controversial, and only few such cases have been reported. We reviewed our experiences regarding living-donor lobar lung transplantation (LDLLT) in patients with pulmonary complications of HSCT. METHODS.: We reviewed and assessed seven patients (age, 6-45 yr) who underwent LDLLT at Okayama University Hospital for pulmonary complications of HSCT (HSCT group). Their characteristics and postoperative results were compared with those of 41 LDLLT without HSCT patients (non-HSCT group). In the HSCT group, indications for LDLLT included bronchiolitis obliterans (n=6) and pulmonary fibrosis (n=1) that had developed after treatments involving HSCT. Preexisting hematologic diseases included acute lymphocyte leukemia (n=4), acute promyelocystic leukemia (n=1), myelodysplastic syndrome (n=1), and aplastic anemia (n=1). RESULTS.: In the HSCT group, two patients died due to infectious complications, whereas five are currently alive (an overall survival of 71.4%) without any recurrence of the hematologic diseases (mean follow-up period, 35.7 months). The mean of acute rejection episodes was 1.1 per patient in the HSCT group and 1.8 in the non-HSCT group. One of the seven HSCT (14.4%) and 10 non-HSCT (24.4%) patients have currently developed bronchiolitis obliterans syndrome. CONCLUSION.: Our results showed that LDLLT for patients with respiratory failure because of pulmonary complications of HSCT could be an effective approach with less rejection episodes; however, it has a possibly higher risk of the development of infectious complications.
AB - BACKGROUND.: The indication of lung transplantation for patients with pulmonary complications of hematopoietic stem cell transplantation (HSCT) remains controversial, and only few such cases have been reported. We reviewed our experiences regarding living-donor lobar lung transplantation (LDLLT) in patients with pulmonary complications of HSCT. METHODS.: We reviewed and assessed seven patients (age, 6-45 yr) who underwent LDLLT at Okayama University Hospital for pulmonary complications of HSCT (HSCT group). Their characteristics and postoperative results were compared with those of 41 LDLLT without HSCT patients (non-HSCT group). In the HSCT group, indications for LDLLT included bronchiolitis obliterans (n=6) and pulmonary fibrosis (n=1) that had developed after treatments involving HSCT. Preexisting hematologic diseases included acute lymphocyte leukemia (n=4), acute promyelocystic leukemia (n=1), myelodysplastic syndrome (n=1), and aplastic anemia (n=1). RESULTS.: In the HSCT group, two patients died due to infectious complications, whereas five are currently alive (an overall survival of 71.4%) without any recurrence of the hematologic diseases (mean follow-up period, 35.7 months). The mean of acute rejection episodes was 1.1 per patient in the HSCT group and 1.8 in the non-HSCT group. One of the seven HSCT (14.4%) and 10 non-HSCT (24.4%) patients have currently developed bronchiolitis obliterans syndrome. CONCLUSION.: Our results showed that LDLLT for patients with respiratory failure because of pulmonary complications of HSCT could be an effective approach with less rejection episodes; however, it has a possibly higher risk of the development of infectious complications.
KW - Bone marrow transplantation
KW - Bronchiolitis obliterans
KW - Living-donor lobar lung transplantation
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U2 - 10.1097/TP.0b013e318190b0be
DO - 10.1097/TP.0b013e318190b0be
M3 - Article
C2 - 19104419
AN - SCOPUS:58849152832
VL - 86
SP - 1767
EP - 1770
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 12
ER -