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Status of lung transplantation
1Division of Thoracic Surgery, University of Toronto, Ontario, Canada.
The Surgical Clinics of North America
|June 1, 1988
Summary
Lung transplantation effectively manages terminal lung disease in select patients. Careful donor/recipient selection and surgical techniques improve outcomes, with procedure choice depending on the specific pulmonary condition.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Transplantation Medicine
Background:
- Lung transplantation is a critical treatment for end-stage lung disease.
- Patient selection and surgical strategy significantly impact transplant success.
Purpose of the Study:
- To review the management of terminal lung disease using lung transplantation.
- To outline appropriate surgical procedures based on underlying pulmonary pathology.
- To identify ongoing challenges and areas for research in lung transplantation.
Main Methods:
- Review of current practices in lung transplantation for various pulmonary diseases.
- Analysis of factors influencing transplant success, including patient selection and perioperative care.
- Discussion of different surgical approaches: single-lung, double-lung, and heart-lung transplantation.
Main Results:
- Strict donor and recipient selection criteria enhance transplant success.
- Perioperative corticosteroid avoidance is crucial for better outcomes.
- Single-lung transplantation is optimal for pulmonary fibrosis.
- Double-lung transplantation suits emphysema or septic disease with preserved cardiac function.
- Combined heart-lung transplantation is indicated for right-heart failure due to pulmonary vascular or parenchymal disease.
Conclusions:
- Lung transplantation offers effective management for select patients with terminal lung disease.
- Procedure selection (single, double, or heart-lung) must be tailored to the specific disease.
- Donor availability, airway healing, and rejection diagnosis remain key challenges requiring further investigation.