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[Lung transplantation].

P Bonnette1

  • 1Groupe de Transplantation Pulmonaire et Service de Chirurgie Thoracique, Hôpital Foch, 40, rue Worth, 92151 Suresnes. p.bonnette@hopital-foch.org

Revue De Pneumologie Clinique
|May 11, 2004
PubMed
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Lung transplantation offers a life-saving option for severe lung diseases like cystic fibrosis and pulmonary hypertension. Despite risks including rejection and limited organ availability, advancements improve patient survival and quality of life.

Area of Science:

  • Pulmonary Medicine
  • Transplant Surgery

Context:

  • Lung transplantation is a critical intervention for end-stage lung diseases.
  • Patients with cystic fibrosis, emphysema, pulmonary fibrosis, and pulmonary hypertension are candidates.
  • Limited donor organ availability significantly impacts patient access and outcomes.

Purpose:

  • To outline the indications, types, and outcomes of lung transplantation.
  • To detail the challenges and risks associated with lung transplant procedures.
  • To highlight advancements in immunosuppression and quality of life post-transplant.

Summary:

  • Lung transplantation is indicated for patients with a life expectancy under two years due to conditions like cystic fibrosis, emphysema, pulmonary fibrosis, or pulmonary hypertension.
  • Transplant options include single, bilateral, or heart-lung transplants, chosen based on specific disease criteria.

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  • Key challenges include donor organ scarcity, leading to waitlist mortality, and postoperative complications such as graft dysfunction, infection, and rejection.
  • Acute and chronic rejection, particularly obliterating bronchiolitis, remain significant threats post-transplant, alongside risks of cancer and adverse effects from immunosuppressive therapy.
  • Despite a 15% two-month mortality and 50% five-year survival, improvements in immunosuppression have enhanced graft function and patient quality of life.

    • Impact:

    • Provides critical insights into the current state and challenges of lung transplantation.
    • Informs clinical decision-making regarding patient selection and management.
    • Underscores the need for improved organ donation strategies and post-transplant care to enhance long-term survival and patient well-being.