Indication and recipient selection for lung transplantation

Lung Transplantation has become an established therapeutic modality for selected patients with end-stage lung diseases including chronic obstructive lung disease(COPD). Candidates for lung transplantation should have chronic disease for which no further medical or surgical therapy is available and survival is limited. Disease specific guidelines of lung transplant candidates for COPD patients include FEV1.0 < 25% of predicted, PaCO2 > 55 Torr or cor pulmonale. As of August 2003, 13 cadaveric lung transplantation and 31 living-donor lobar transplantation has been performed in Japan, and 38 of 44 recipients are alive. The shortage of cadaveric donors, infection and chronic rejection are the major problems in lung transplantation and every endeavor must be made to solve them.