[Present status of lung transplantation and heart-lung transplantation]

On the basis of development of the immunosuppressive drugs such as cyclosporine since 1981, many successful cases have been reported on clinical lung and heart-lung transplantations. A principal disease for a single lung transplantation is pulmonary fibrosis. Obstructive lung disease and bilateral pulmonary sepsis such as cystic fibrosis and bronchiectasis are now considered to be done double lung transplantation. On the other hand, heart-lung transplantations have been performed not only on primary pulmonary hypertension and Eisenmenger's syndrome but also on restrictive and/or obstructive lung disease. Today's subjects on lung and heart-lung transplantations are as follows 1) The establishment of preservation method of transplant organs. 2) Development of an appropriate technique of monitoring for the rejected lungs. 3) Assessment and improvement of bronchial anastomotic healing. 4) Investigation of the causal factors on reimplantation response and obliterative bronchitis. Long-term survivals have been reported in both lung and heart-lung transplantation. Therefore, many attempts have been increasingly made in order to obtain the heart beating cadaver donors in Japan. But experimental study on the unsolved problems of transplantation should be continuously carried out for successful clinical lung and heart-lung transplantation.