Late living-donor kidney transplantation from the same donor after living-donor lobar lung transplantation

Chronic kidney disease (CKD) is a common late complication associated with increased mortality after lung transplantation. Given the increased risk of infection in dialysis patients, late living-donor kidney transplantation (LDKT) provides excellent long-term survival in patients on dialysis after lung transplantation. However, recipients of living-donor lobar lung transplantation (LDLLT) might have scarce opportunity to receive LDKT due to the limited availability of living donors (LDs) for the second transplantation. We describe a successful case of late LDKT from the same donor after LDLLT. A 23-year-old woman with lymphangioleiomyomatosis underwent bilateral LDLLT of the right lower lobe from her brother and left lower lobe from her mother. Twelve years after LDLLT, she required hemodialysis for severe CKD. At the age of 37, she underwent LDKT from her mother, who was also an LD for the LDLLT. The postoperative courses of both the recipient and donor were uneventful, and the recipient remains in good physical condition (at the time of writing) despite developing recurrent lymphangioleiomyomatosis 23 years after the LDLLT, that is, 9 years after the LDKT. Her mother, the dual-organ LD, was able to return to her previous lifestyle. Late LDKT even from the same donor might be a viable option for patients developing severe CKD after LDLLT.