[Prevention and Treatment Strategy for Infectious Complication after Lung Transplantation]

The most frequent cause of death within a year after lung transplantation is infectious complications, which shifts to chronic allograft rejection or chronic lung allograft dysfunction(CLAD) thereafter. It is no doubt that minimization of the dose of immunosuppression within the acceptable therapeutic range is a best strategy to avoid infectious complications however, adequate dose of immunosuppressant is mandatory to protect lung allografts from acute or chronic rejection. Carefully balanced therapy of immunosuppression and infection control is extremely important for patient's long term survival after lung transplantation. Total 344 transplants were performed in Japan until the end of 2013, and the 5-year post-operative survival was reported as more than 70% which is superior than North American or European registry data. However, more than 30% of death is still caused by infectious complications thus appropriate prevention and treatment for infection is important for better long term results. Here in this paper, the 1st 10-year experience of Fukuoka University Lung Transplant Program was reported and discussed especially focusing on infectious complications.