On April 7, 2021, a living-donor lung transplantation for lung injury after infection with the SARS-CoV-2 was performed at a national university hospital in Japan. This is the first case of lung transplant surgery for lung injury after infection with the SARS-CoV-2 in Japan. Furthermore, this is the world's first case of living-donor lung transplantation for lung injury after infection with the SARS-CoV-2.

Prior to the implementation of this surgical treatment, on April 5, 2021, the patient was transported from a general hospital in the Kansai area. The medical team of respiratory surgery at the national university hospital accepted the patient without delay, with the cooperation of the medical staff of the emergency department and the infection control department. The result of PCR testing for SARS-CoV-2 on the patient was negative. The medical staff determined that recovery of the patient's lung function was unlikely. Therefore, the medical staffs transplanted a part of the patient's son's a portion of the right lung and the patient's husband's a portion of the left lung as the patient's right and left lungs for a patient who had been treated with ECMO (extracorporeal membrane oxygenation) for about 3 months after infection with the SARS-CoV-2. Because the waiting period exceeded 800 days, it was not possible to perform brain death lung transplantation.

Postoperative course Immediately after surgery: Patient is weaned from ECMO
Day 13: Patient is weaned from ventilator
Day 26: Patient moved from ICU to general ward
Day 60: Patient began gait training
Day 75: Patient is completely weaned from ventilator
Day 131 (16 August 2021): Patient transferred for rehabilitation purposes

Twenty to 40 cases of lung transplantation for lung injury after infection with the new coronavirus have been performed in China, Europe, and the United States, but all cases of the lung transplantations were brain-death lung transplantations. This case, performed at a national university hospital in Japan, is the world's first living-donor lung transplant. Brain-dead lung donors are in short supply. In the future, living-donor lung transplantation is expected to become a hopeful treatment for patients who have developed severe lung damage as a sequela of SARS-CoV-2 infection.

We do not have potential conflicts of interest.

Published in JAMA on August 27, 2023, by Kyoto@takumaH
Doctor specializing in cancer medicine.
Doctor specializing in emerging infectious diseases.