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Updated: Jun 5, 2025
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Lung Transplantation—Indications, Follow-Up Care and Long-Term Results
Sebastian Michel1, Christian Schneider, Fabio Ius
1Department of Cardiac Surgery, LMU Hospital Munich, and Munich Heart Alliance, German Center for Cardiovascular Research (DZHK), Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research (DZL), Munich, Germany; Division for Thoracic Surgery, LMU Hospital Munich, Germany; Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Gemany; Biomedical Research in Endstage & Obstructive Lung Disease Hannover (BREATH),German Center for Lung Research (DZL), Hannover, Germany; Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Germany; Medical Clinic and Polyclinic V, Pneumology, LMU Hospital Munich, and Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Austria.
Background:
Lung transplantation is the treatment of choice for end-stage nonmalignant lung disease. It has become a routine procedure through advances in donor lung preservation, extracorporeal membrane oxygenation, immunosuppression, intensive care medicine, and follow-up care.
Methods:
This review is based on publications about lung transplantation that were retrieved by a selective literature search, and on the procedures and experience of two large-volume lung transplantation centers.
Results:
The mean survival time after lung transplantation is six years, which is the shortest after the transplantation of any solid organ. Chronic graft dysfunction is present in 41% of patients at five years and is the main cause of death after lung transplantation, followed by infection and cancer.
Conclusion:
Despite all the advances in lung transplantation, acute and-above all-chronic graft dysfunction still pose a major challenge for large-volume transplantation centers. Immunosuppression that is individually tailored to prevent both graft rejection and infection is important for these patients' longterm survival. Xenotransplantation and so-called lung bioengineering may become available in the future as alternatives to allotransplantation.
