Registry of the Japanese Society of Lung and Heart-Lung Transplantation: official Japanese lung transplantation report, 2014

The number of organ donations after brain death has significantly increased since the revised Japanese Organ Transplant Law took effect in July 2010. Sixty-one lung transplantations were conducted throughout Japan in 2013, including 20 living-donor lung transplantations and 41 brain-dead-donor lung transplantations (23 bilateral lungs, 17 single lungs, and 1 heart-lung transplantation). The number of lung transplant candidates newly registered at the Japan Organ Transplantation Network also increased to 126 in 2013, suggesting a severe donor shortage in Japan. More than 60 % of offered brain-dead-donor, lungs were used for transplantation, indicating the effort of Japanese lung transplant centers to overcome the challenge of donor shortage. After lung transplantation, patients generally enjoyed a good quality of life with excellent survival of 86.2 % at 1 year, 79.6 % at 3 years, and 73.7 % at 5 years post-transplantation. There was no significant difference in patient survival between living-donor and brain-dead-donor lung transplantation. Early mortality of lung transplant recipients within 90 days was attributable to graft failure followed by infection, while long-term mortality was mostly explained by chronic lung allograft dysfunction (chronic rejection), infection, and malignancy. Eight lung transplant centers are currently approved to conduct lung transplantation in Japan (Tohoku, Dokkyo, Chiba, Kyoto, Osaka, Okayama, Fukuoka, and Nagasaki Universities). These centers are expected to continue to make a special effort to save critically ill patients waiting for lung transplantation.