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[Lung transplantation].

Patricio Santillán-Doherty1, Rogelio Jasso-Victoria, Raúl Olmos-Zúñiga

  • 1Departamento de Cirugía Experimental, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, DF. psantdod@quetzal.innsz.mx

Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion
|March 10, 2006
PubMed
Summary

Lung transplantation (LT) offers a vital option for end-stage lung disease. While historical roots are deep, clinical success emerged in the 1980s, with survival rates improving but challenges like rejection and infection persisting.

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Area of Science:

  • Medical Science
  • Surgical Innovation
  • Pulmonary Medicine

Background:

  • Lung transplantation (LT) has become a critical treatment for end-stage pulmonary disease and chronic respiratory failure.
  • Historical milestones include early experiments and the first clinical attempt in 1963, with significant progress in the 1980s.
  • Patient selection criteria are well-defined, addressing various etiologies of lung damage such as COPD, fibrosis, cystic fibrosis, and pulmonary hypertension.

Purpose of the Study:

  • To provide a comprehensive overview of lung transplantation.
  • To discuss the evolution, indications, methods, challenges, and outcomes of LT.
  • To highlight the significance of donor factors and preservation techniques.

Main Methods:

  • Review of historical data and clinical advancements in lung transplantation.

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  • Classification of end-stage lung diseases necessitating transplantation.
  • Description of surgical techniques including single lung, bilateral sequential, and cardiopulmonary transplantation.
  • Discussion of donor lung quality, preservation methods, and post-transplant management.

    • Main Results:

    • Current one-year survival rates for LT range from 65-70%, decreasing to 40-45% by five years.
    • Early mortality is often attributed to primary graft failure and infection.
    • Long-term survival is impacted by managing infections related to immunosuppression and chronic rejection, such as bronchiolitis obliterans.

    Conclusions:

    • Lung transplantation is a life-saving procedure for carefully selected patients with end-stage respiratory failure.
    • Ongoing challenges include optimizing donor lung utilization, improving preservation, and mitigating post-transplant complications like infection and chronic rejection.
    • Continued research and advancements are crucial for enhancing long-term outcomes in lung transplant recipients.