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Which patients should receive lung transplants?

B P Madden1, D M Geddes

  • 1Royal Brompton National Heart & Lung, Hospital, London, UK.

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|August 1, 1993
PubMed
Summary

Lung transplantation offers a vital option for end-stage respiratory failure. Advances in surgical techniques and immunosuppression have improved outcomes, though challenges like obliterative bronchiolitis persist.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Transplant Surgery

Background:

  • Lung transplantation is a critical treatment for end-stage respiratory failure due to various lung diseases.
  • Historically, heart-lung transplantation avoided bronchial anastomosis issues due to intact collateral circulation.
  • Declining availability of heart-lung blocks necessitates alternative strategies.

Purpose of the Study:

  • To review the evolution and current status of lung transplantation techniques.
  • To discuss patient selection criteria and pre-transplant assessments.
  • To highlight advancements in immunosuppression and post-operative care.

Main Methods:

  • Review of surgical techniques including double lung, bilateral single lung, and single lung transplantation.
  • Assessment of patient selection criteria, medical, and psychosocial evaluations.
  • Analysis of outcomes with improved immunosuppressive agents and post-operative care.

Main Results:

  • Improved surgical techniques offer viable alternatives to heart-lung transplantation with good results.
  • Advances in immunosuppression and post-operative care have enhanced survival and quality of life.
  • Obliterative bronchiolitis remains a significant post-transplant complication.

Conclusions:

  • Lung transplantation is a viable therapeutic option for selected patients with end-stage respiratory failure.
  • Modern techniques and improved care have led to encouraging outcomes, despite ongoing challenges.
  • Future developments, including xenografting, may expand treatment options.

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