Living donor (LD) lung transplantation (LT) represents an exceptional procedure in Western countries. However, in selected situations, it could be a source of unique advantages, besides addressing organ shortage. We report a successful case of father-to-child single-lobe LT, because of the complications of hematopoietic stem cell transplantation from the same donor, with initial low-dose immunosuppressive therapy and subsequent early discontinuation. Full donor chimerism was hypothesized to be a mechanism of transplant tolerance, and this postulated immunological benefit was deemed to outweigh the risks of living donation and the possible drawbacks of single compared with bilateral LT. Favorable size matching and donor’s anatomy, accurate surgical planning, and specific expertise in pediatric transplantation also contributed to the optimal recipient and donor outcomes. Ten months after LD LT, the patient’s steadily good lung function after withdrawal of immunosuppressive therapy seems to confirm the original hypothesis.

中文翻译：

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同一捐献者造血干细胞移植后的活体肺移植：值得冒的风险

活体供体（LD）肺移植（LT）在西方国家是一种特殊的手术。然而，在某些情况下，除了解决器官短缺问题之外，它还可能成为独特优势的来源。我们报告了一个成功的父子单叶 LT 病例，原因是来自同一供体的造血干细胞移植的并发症，最初采用低剂量免疫抑制治疗，随后提前停药。完全供体嵌合被假设为移植耐受的一种机制，并且这种假设的免疫学益处被认为超过了活体捐赠的风险以及单次 LT 与双侧 LT 相比可能存在的缺点。有利的尺寸匹配和供体的解剖结构、准确的手术计划以及儿科移植方面的具体专业知识也有助于获得最佳的受体和供体结果。 LD LT 十个月后，患者在停止免疫抑制治疗后肺功能稳定良好，似乎证实了最初的假设。