Pulmonary lobe homotransplantation in human subjects

Abstract

Abstract Homologous transplantation of the lung was performed in a human subject with bilateral bronchiectasis. This patient presented the added difficulty of persistent hemoptysis associated with low pulmonary function. Operation was performed using the uninvolved lower lobe removed from a patient with pulmonary cancer of the upper lobe of the left lung after resection of the recipient's lingula and lower lobe of the left lung from which the hemoptysis was presumed to have originated. It was necessary, however, to remove the transplanted lung again because of pulmonary edema which developed on the eighteenth day after transplantation although the remaining lung had expanded well by this time. Radiocirculogram of the lung using RISA, angiography, and analysis of blood gas confirmed the maintenance of pulmonary blood flow and respiratory function of the transplanted pulmonary lobe at the time pulmonary edema developed. We also learned that the rejection reaction was not histologically identified in the tissue of the transplanted pulmonary lobe. This report of homologous transplantation of the lung in a human subject is believed to represent the first case from Japan and the fourth case in the world. It may be considered the first case in the world from the viewpoint of transplantation of the pulmonary lobe used as a temporary supplement to pulmonary function. This case suggests another clinical application of homologous lung transplantation at present time.