[Retransplantation after Bilateral Living-donor Lobar Lung Transplantation]

Living-donor lobar lung transplantation( LDLLT) is an established therapy for patients with end-stage lung disease, but living-donor lobar lung retransplantation (re-LDLLT) is rarely reported. We previously reported a case of unilateral antibody-mediated rejection (AMR) after bilateral LDLLT in the presence of newly formed donor-specific antibodies against a right-lobe donor. The same patient developed contralateral bronchiolitis obliterans syndrome (BOS), resulting in bilateral BOS. Re-LDLLT was performed under extracorporeal membrane oxygenation. Eight and a half years after re-LDLLT, the patient is doing well without any anti-human leukocyte antigen antibodies. Four lobes from four different donors were transplanted in this patient. Herein, we report this rare case and discuss several issues in comparison with the findings in the previously reported similar cases.