Evolving Techniques and Perspectives in Lung Transplantation

Lung transplantation is currently a suitable option for patients with end-stage lung disease. Since the early 1980s the surgical technique and immunosuppressive protocols have been progressively modified to improve results and favor long-term survival. The original heart-lung transplantation under c...

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Bibliographic Details
Published in:Transplantation proceedings 2005-07, Vol.37 (6), p.2682-2683
Main Authors: Venuta, F., Diso, D., Anile, M., Aratari, M.T., Francioni, F., Pugliese, F., Rendina, E.A., Coloni, G.F.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Humans
Lung Transplantation - adverse effects
Lung Transplantation - methods
Lung Transplantation - trends
Medical sciences
Postoperative Complications - epidemiology
Reperfusion Injury - epidemiology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Survivors
Tissue Donors - supply & distribution
Tissue, organ and graft immunology
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Summary:Lung transplantation is currently a suitable option for patients with end-stage lung disease. Since the early 1980s the surgical technique and immunosuppressive protocols have been progressively modified to improve results and favor long-term survival. The original heart-lung transplantation under cardiopulmonary bypass is now rarely performed and single or bilateral lung transplantation is the procedure of choice. Bilateral transplantation is performed with two single lung transplants performed in sequence. Extracorporeal support is rarely employed and in most cases it is instituted through the femoral approach. Also, the surgical approach has been modified and the original clam shell incision has been replaced by two small anterior thoracotomies. The use of marginal donors has been increasingly proposed to enlarge the number of organs potentially available for transplantation. Immunosuppressive protocols have evolved to patient-specific regimens that can be quickly modified if required by the clinical status. Induction is now more aggressive and also rescue protocols for obliterative bronchiolitis can contribute to improved outcomes. Overall, lung transplantation is now performed with encouraging long-term results.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2005.06.038