[Living-donor lobar lung transplantation for pediatric patients]

Under the current organ transplantation regulations in Japan, living-donor lobar lung transplantation (LDLLT) is the only realistic option for pediatric patients with end-stage lung disease. Common indications are idiopathic pulmonary arterial hypertension and bronchiolitis obliterans. Both bilateral transplantation and single lobar lung transplantation have been performed successfully in small children. Forced vital capacity increases after LDLLT in growing children. In the author's personal experience, 13 of 14 (93%) pediatric recipients are currently alive for as long as 9 years. Dramatic improvement in quality of life was also observed. These results indicate that LDLLT is a viable option for pediatric patients with end-stage lung disease. A new organ transplantation law, which takes effect from July 2010, will give hope to sick children who do not have suitable living donors in their families.