[Indications for lung transplantation and its selection of the candidates in Japan]

Although the annual number of lung transplant operation performed in the United States and Europe is over 1000, five year survival rate is under 50%, mainly because of obstructive bronchiolitis that is considered chronic rejection. Lung transplantation may be difficult to justify on the ground of survival consideration alone for the certain disease, such as emphysema and pulmonary hypertension. But functional recovery after lung transplantation especially, bilateral is reported very good. Among the diseases of indication of lung transplant, Cystic Fibrosis and alpha antitrypsin deficiency are very rare disease in Japan and emphysema that is most frequently reported indication in the United States, is also rare disease in the age group of lung transplantation candidate. So, idiopathic interstitial pneumonitis, pulmonary vascular disease and other miscellaneous disease are most possible indications for lung transplantation in Japan. These disease have different prognosis, we discussed the timing of registration and operation of lung transplantation in each disease.