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Pulmonary transplantation

R D Davis1, M K Pasque

  • 1Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.

Annals of Surgery
|January 1, 1995
PubMed
Summary

Lung transplantation has advanced significantly, achieving high survival rates. Key challenges remain donor shortages and obliterative bronchiolitis, impacting long-term lung transplant outcomes.

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Area of Science:

  • Thoracic surgery
  • Transplantation medicine
  • Pulmonary critical care

Background:

  • Over 2700 lung transplants performed since 1983.
  • Significant advancements in donor management, preservation, surgical techniques, immunosuppression, and follow-up care.
  • Increasing use of marginal donors and living donors due to organ shortages.

Purpose of the Study:

  • Review the evolution of lung transplant techniques and patient management.
  • Analyze the impact of these changes on transplant outcomes.
  • Highlight current challenges and controversial issues in lung transplantation.

Main Methods:

  • Review of changes in lung transplant techniques.
  • Analysis of patient selection and management strategies.
  • Identification of controversial issues and persistent problems.

Main Results:

  • One-year survival rates exceed 90% for single-lung and 85% for bilateral transplants.
  • Significant reduction in airway complication rates.
  • Obliterative bronchiolitis affects 20-50% of long-term survivors, a primary cause of late morbidity and mortality.

Conclusions:

  • Lung transplantation is an effective treatment for end-stage lung disease.
  • Addressing donor shortages and obliterative bronchiolitis is crucial for expanding lung transplant applicability.

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