Current status of inhaled nitric oxide therapy for lung transplantation in Japan: A nationwide survey

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  • Yoshiyasu Nobuyuki
    Department of Thoracic Surgery, The University of Tokyo Hospital
  • Sato Masaaki
    Department of Thoracic Surgery, The University of Tokyo Hospital
  • Nakajima Daisuke
    Department of Thoracic Surgery, Kyoto University Hospital
  • Tomioka Yasuaki
    Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Watanabe Yui
    Department of Thoracic Surgery, Tohoku University Hospital
  • Shiraishi Takeshi
    Department of Thoracic, Breast and Endocrine, and Pediatric Surgery, Fukuoka University Hospital
  • Funaki Soichiro
    Department of General Thoracic Surgery, Osaka University Hospital
  • Maeda Sumiko
    Department of General Thoracic Surgery, Dokkyo Medical University Hospital
  • Tomoshige Koichi
    Department of Surgery, Division of Surgical Oncology, Nagasaki University Hospital
  • Nakajima Takahiro
    Department of General Thoracic Surgery, Chiba University Hospital
  • Tsuchiya Tomoshi
    Department of Surgery, Division of Surgical Oncology, Nagasaki University Hospital
  • Sugimoto Seiichiro
    Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Yoshino Ichiro
    Department of General Thoracic Surgery, Chiba University Hospital
  • Nagayasu Takeshi
    Department of Surgery, Division of Surgical Oncology, Nagasaki University Hospital
  • Chida Masayuki
    Department of General Thoracic Surgery, Dokkyo Medical University Hospital
  • Minami Masato
    Department of General Thoracic Surgery, Osaka University Hospital
  • Okada Yoshinori
    Department of Thoracic Surgery, Tohoku University Hospital
  • Toyooka Shinichi
    Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Date Hiroshi
    Department of Thoracic Surgery, Kyoto University Hospital
  • Nakajima Jun
    Department of Thoracic Surgery, The University of Tokyo Hospital

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Other Title
  • 本邦における肺移植時の一酸化窒素（NO）ガス使用状況に関する実態調査

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Abstract

<p>Background: Currently, inhaled nitric oxide (NO) therapy for lung transplantation is not covered by public health insurance in Japan. In this study, we evaluated the perioperative use and safety of inhaled NO therapy for lung transplantation.</p><p>Methods: Data regarding the duration of treatment and adverse events of inhaled NO therapy were collected for all lung transplantations performed from January 1, 2015, to December 31, 2019, at nine lung transplant facilities in Japan.</p><p>Results: During the study period, lung transplants were performed for 357 patients, among whom inhaled NO therapy was administered to 349 patients (98%). The median initial and median maximum inhaled NO doses were 10 and 20 ppm, respectively. Inhaled NO therapy was introduced during surgery and continued postoperatively in 313 patients (90%) for a median of 4 days. Significant improvements in oxygenation and decreases in pulmonary arterial pressure were observed in patients receiving inhaled NO therapy. Side effects of inhaled NO therapy, such as methemoglobinemia, were observed in 15 patients (4%), with a significant incidence in patients aged < 18 years.</p><p>Conclusions: Inhaled NO therapy was performed for almost all patients who underwent lung transplantation in Japan and showed reasonable efficacy. Therefore, public health insurance coverage for inhaled NO therapy during lung transplantation is recommended.</p>

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