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Kidney Transplant I: Introduction01:28

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...

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Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation
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Lung transplantation for interstitial lung disease.

Nicola J Ronan1,2, Feargal Helly1, Michelle A Murray1,2

  • 1National Heart and Lung Transplant Unit, Mater Misericordiae University Hospital, Dublin, Ireland.

Breathe (Sheffield, England)
|May 14, 2025
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Summary

Interstitial lung diseases (ILDs) are the leading reason for lung transplantation. Early referral for pulmonary rehabilitation and multidisciplinary assessment are crucial for improving outcomes in ILD patients awaiting lung transplants.

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Area of Science:

  • Pulmonology
  • Transplant Surgery

Background:

  • Interstitial lung diseases (ILDs) represent the most frequent indication for lung transplantation globally.
  • Older age and frailty are common in lung transplant candidates with idiopathic pulmonary fibrosis, necessitating pulmonary rehabilitation.
  • Many ILD patients who could benefit from lung transplantation are referred late or not at all.

Purpose of the Study:

  • To highlight the challenges and considerations in lung transplantation for ILD patients.
  • To emphasize the importance of multidisciplinary assessment and pulmonary rehabilitation.
  • To discuss the evolving evidence for lung transplantation in rare ILDs and the role of palliative care.

Main Methods:

  • Review of current practices and evidence in lung transplantation for ILDs.
  • Analysis of factors influencing outcomes, including age, comorbidities, and organ availability.
  • Consideration of single versus bilateral lung transplant decisions.

Main Results:

  • Increasing age and comorbidities present significant challenges in ILD lung transplantation.
  • Donor lung sizing and the risk-benefit analysis of transplant type are critical considerations.
  • Evidence is emerging for lung transplantation in rarer ILDs, such as those associated with surfactant protein deficiencies and TERT mutations.

Conclusions:

  • Lung transplantation for ILD is complex, requiring careful management of patient factors and surgical decisions.
  • Palliative care is essential for patients on the lung transplant waiting list to manage symptoms and improve quality of life.
  • Addressing organ shortages and optimizing patient selection remain critical challenges in ILD lung transplantation.