Effect of revised organ transplant law in Japan on lung transplantation

Yoshito Imamura; Daisuke Nakajima; Takashi Kanou; Yasushi Shintani; Seiichiro Sugimoto; Shinichi Toyooka; Yasushi Hoshikawa; Keitaro Matsumoto; Takeshi Nagayasu; Hidemi Suzuki; Sumiko Maeda; Masayuki Chida; Takeshi Shiraishi; Toshihiko Sato; Masaaki Sato; Jun Nakajima; Hisashi Oishi; Yoshinori Okada; Hiroshi Date

doi:10.1007/s00595-024-02839-5

Effect of revised organ transplant law in Japan on lung transplantation

Surg Today. 2024 Apr 15. doi: 10.1007/s00595-024-02839-5. Online ahead of print.

Authors

Yoshito Imamura^{1

2}, Daisuke Nakajima³, Takashi Kanou⁴, Yasushi Shintani⁴, Seiichiro Sugimoto⁵, Shinichi Toyooka⁵, Yasushi Hoshikawa⁶, Keitaro Matsumoto⁷, Takeshi Nagayasu⁷, Hidemi Suzuki⁸, Sumiko Maeda⁹, Masayuki Chida⁹, Takeshi Shiraishi¹⁰, Toshihiko Sato¹⁰, Masaaki Sato¹¹, Jun Nakajima¹¹, Hisashi Oishi¹², Yoshinori Okada¹², Hiroshi Date¹

Affiliations

¹ Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
² Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
³ Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan. daink@kuhp.kyoto-u.ac.jp.
⁴ Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
⁵ Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
⁶ Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
⁷ Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
⁸ Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
⁹ Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Japan.
¹⁰ Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
¹¹ Department of Thoracic Surgery, The University of Tokyo, Tokyo, Japan.
¹² Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.

PMID: 38619591
DOI: 10.1007/s00595-024-02839-5

Abstract

Purpose: To investigate how revision of the organ transplant law in Japan affected lung transplantation in this country.

Methods: Lung transplant candidates registered between January, 2000 and December, 2009 were designated as the pre-revision group (n = 396) and those registered between January, 2011 and December, 2020, as the post-revision group (n = 1326). Both groups were analyzed retrospectively using data collected by the Japanese Society of Lung and Heart-Lung Transplantation.

Results: The number of patients who underwent brain-dead donor lung transplantation (BDLT) increased significantly after the law amendment (32.2 vs. 13.8%, p < 0.01). The median waiting time for BDLT was significantly reduced (708 days vs. 1163 days, p < 0.01) and the mortality rate while waiting for BDLT improved significantly after the law amendment (33.1 vs. 42.6%, p < 0.01). In the post-revision group, 18 pediatric patients underwent BDLT. The 5-year survival rates after BDLT were comparable between the groups (73.5% in the pre-revision group vs. 73.2% in the post-revision group, p = 0.32).

Conclusions: The organ transplant law revision shortened the waiting time for BDLT significantly and decreased the mortality rate while waiting for BDLT. The posttransplant outcomes in Japan remained favorable throughout the study period.

Keywords: Brain-dead donor; Living donor; Lung transplantation; Organ transplant law.