• Stefania Camagni, Lorenzo D'Antiga, Fabiano Di Marco, Lorenzo Grazioli, Ezio Bonanomi, Domenico Pinelli, Marta Beretta, Veronica Tintori, Alessandro Lucianetti, and Michele Colledan.
• Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy. Electronic address: scamagni@asst-pg23.it.
• Chest. 2024 Apr 1; 165 (4): e91e93e91-e93.

AbstractLiving 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.Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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