Increasing evidence suggests that size-reduced lung transplants (graft volume reduction and lobar lung transplant) are beneficial to recipients receiving oversized allografts.3,4 Shigemura et al5 investigated lung volume reduction as an efficient tool for reducing short-term complications and improving pulmonary function in patients with size-mismatched allografts. A special approach for overcoming severe size disparities is lobar transplant, which is especially useful in pediatric lung transplants involving a small thorax cavity. Loizzi et al6 suggested the pTLC ratio as a marker of lobar transplant based on a receiver operating characteristic analysis: Patients with oversized allografts (pTLC ratio >1.2) were considered for a lobar transplant, for which the higher the pTLC ratio, the higher the possibility that the patients were likely to benefit from it. Date et al7 also stated that size disparity in lobar transplants can be accepted when the total FVC of the two grafts is >50% of the predicted FVC of the recipient, estimated by the following formula: Total FVC of the two grafts = measured FVC of the right donor ×5/19 + measured FVC of the left donor ×4/19 (the right lower lobe consists of five segments, the left lower lobe of four, and the whole lung of 19). Date et al7 suggested that in such a case, this is an alternative to conventional cadaveric lung transplant, resulting in a similar outcome. Additionally, comparable clinical outcomes were observed between patients who received size-matched allografts and size-reduced allografts.4,8 However, the authors did not describe in the article the situation of size-reduced lung transplantation for an oversized cohort, implying that lung trimming as a confounding factor may result in significant discrepancy. It would be helpful if this concern could be commented on, and further analysis of the study to address this important issue is required.