肺高血压和肺部移植
Sophie Kruszona1, Khalil Aburahma1, Nunzio Davide de Manna1
1Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Zentralblatt fur Chirurgie
|May 14, 2025
概括
肺移植是肺动脉高血压 (PAH) 的关键治疗方法. 策略已经发展,优先考虑高风险患者,并利用ECMO获得更好的结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 移植医学 移植医学
背景情况:
- 肺动脉高血压 (PAH) 是一种严重的末期肺部疾病.
- 肺移植是PAH的黄金标准治疗方法.
- 在过去的二十年里,PAH的移植策略已经发展.
研究的目的:
- 审查目前关于PAH肺移植的文献.
- 专注于风险分层,捐赠者分配,桥梁策略和术后管理.
- 讨论成人和儿科PAH肺移植的进展.
主要方法:
- 关于PAH肺移植近期进展的文献综述.
- 分析移植指示和策略的变化.
- 评估抗高血压药物和体外膜氧化 (ECMO) 的作用.
主要成果:
- 抗高血压药物延迟了移植,将其保留给高风险患者.
- 身体外膜氧化 (ECMO) 有助于心脏移植后重塑.
- 从心肺移植转移到双边肺移植可以增加器官的可用性.
结论:
- 对于选定的PAH患者来说,ECMO桥梁至关重要,但存在风险.
- 改善高风险PAH患者的器官分配可以减少ECMO的使用并改善结果.
- 双边肺移植越来越受青,而不是PAH的联合心肺移植.
相关概念视频
Pulmonary Hypertension: Classification and Pathogenesis
120
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
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Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
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Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
126
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
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Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
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Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
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Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
120
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
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Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
107


