Research Project on the Clinical Indication in Japan and the Posttransplant Patient Management in Lung and Heart-Lung Transplantation.

(1)临床指征慢性肺气肿占我国肺移植幼年型肺气肿发生率的1%~2%，减容手术作为一种搭桥治疗的益处已经确立。前列环素治疗原发性肺动脉高压的有效性已得到证实，但也有部分患者对此治疗耐药。(2)基础研究1)基础研究1)基础研究1)基础研究1)扩大供体池证明了非心脏跳动供体肺移植的可能性，并开始了活体肺移植大小匹配的研究。2)Zeno移植作为一种低抗原提呈模型的胎肺移植受到了挑战，并提出了它的用途。对肾移植免疫反应机制的研究已取得进展。3)移植后患者的处理血小板被发现在再植反应中起重要作用。雷公藤甲素是一种中药，被发现是一种有效的免疫抑制剂。分子生物学技术(基因转染法)已被广泛应用于肺移植急、慢性排斥反应的免疫抑制。

(1) Clinical indication<Chronic pulmonary emphysema> Incidence of the juvenile type emphysema for lung transplantation in our country was found to be 1 to 2% of all, and the benefit of volume reduction surgery as a bridge therapy has been established.<Primary pulmonary hypertension> Effectiveness of the prostacyclin treatment has been established to date, however, some patients were found to be resistant to this treatment.<Others> Potential candidates for lung transplantation were most frequently found in patients with idiopathic pulmonary fibrosis among several disease entity (idiopathic pulmonary fibrosis, pulmonary lymphoangiomyomatosis, bronchilitis obliterans, pulmonary emphysema).(2) Basic research1) Expansion of the donor poolPossibility of lung transplantation from non-heart-beating donor was demonstrated, and the research on the size matching in living-related lobar transplantation has been started.2) ZenotransplantationFetal lung as a low antigen-presenting model was challenged for zenograft and its usefulness was suggested. Researches on the mechanisms of immune reaction in zenotransplantation has been progressed.3) Posttransplant patient managementPlatelet was found to be contributory in reimplantation response. Triptolide, a kind of Chinese medicine, was found to be a potent immunosuppressive agent. Molecular biological technique (gene transfection) has been strated to be applied for immunosuppression in both acute and chronic rejection in lung transplantation.