Groundbreaking Transplant Doctors Say Surgery Was Last Resort; Three Relatives Donated Organs to Save Young Boy’s Life

The Yomiuri Shimbun

21:00 JST, March 5, 2024

A team of doctors at Kyoto University Hospital stressed Monday that careful consideration preceded the world’s first combined lung and liver transplantation from living donors.

“We discussed the surgery many times and concluded it was the only way to save [the boy’s] life,” one of the doctors said at a press conference.

In the surgery, which was performed successfully on Nov. 15, the lungs and part of the liver from a total of three relatives were transplanted into a boy who had not yet turned 10. The boy, who suffers from a genetic disorder known as dyskeratosis congenita, recovered well enough to walk from his room to a convenience store in the hospital before being discharged Friday.

He was referred to Kyoto University Hospital by a hospital in the Kanto region about two years ago. Before the surgery, he spent most of his days in bed, as the poor condition of his lungs required the use of an oxygen tank.

Later, he developed cirrhosis, which affects the liver. This prompted Kyoto University Hospital to propose the combined lung-liver transplantation to his family in August last year.

“The state of the boy suggested that he would die if we didn’t do the transplant,” said Prof. Hiroshi Date, who performed the surgery.

However, living donations place a heavy burden on donors. The doctors thoroughly discussed the necessity of the operation. “We talked about whether it was really worth removing the organs of three relatives for the sake of one boy,” Date said.

The doctors continued to hold dialogues with the family all the way up to the day of the surgery, but the relatives’ determination reportedly remained steadfast.

The parents said in a statement that they initially thought there was nothing more they could do and that organ transplantation was their only hope.

“We’d really be happy if this surgery can be a glimmer of hope for patients and their families who have no choice but to give up,” they said.

The hospital performed the groundbreaking surgery even though the government has yet to establish a system for combined lung-liver transplantations using organs donated from brain-dead people.

According to The Japan Society for Transplantation and other organizations, dozens of combined lung-liver transplantations using organs donated from brain-dead people have been performed overseas.

In Japan, however, combined transplants from brain-dead donors have been limited to the combinations of liver and kidney or heart and lung, for instance, which cover many eligible patients in Japan.

Combined lung-liver transplantation is only available for people suffering from dyskeratosis congenita and a few other diseases. But Nagasaki University Prof. Susumu Eguchi, who is also vice president of the society, said: “With the number of brain-dead donors increasing in Japan, it’s time to consider combined lung-liver transplantations from brain-dead donors.”