Lung Transplantation - Indications, Follow-Up Care and Long-Term Results.

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Deutsches Arzteblatt international Pub Date : 2025-01-24 DOI:10.3238/arztebl.m2024.0232
Sebastian Michel, Christian Schneider, Fabio Ius, Tobias Welte, Jens Gottlieb, Nikolaus Kneidinger
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Abstract

Background: Lung transplantation is the treatment of choice for end-stage nonmalignant lung disease. It has become a routine procedure through advances in donor lung preservation, extracorporeal membrane oxygenation, immunosuppression, intensive care medicine, and follow-up care.

Methods: This review is based on publications about lung transplantation that were retrieved by a selective literature search, and on the procedures and experience of two large-volume lung transplantation centers.

Results: The mean survival time after lung transplantation is six years, which is the shortest after the transplantation of any solid organ. Chronic graft dysfunction is present in 41% of patients at five years and is the main cause of death after lung transplantation, followed by infection and cancer.

Conclusion: Despite all the advances in lung transplantation, acute and - above all - chronic graft dysfunction still pose a major challenge for large-volume transplantation centers. Immunosuppression that is individually tailored to prevent both graft rejection and infection is important for these patients' long-term survival. Xenotransplantation and so-called lung bioengineering may become available in the future as alternatives to allotransplantation.

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背景:肺移植是治疗终末期非恶性肺病的首选方法。通过在供体肺保存、体外膜肺氧合、免疫抑制、重症监护医学和后续护理方面的进步,肺移植已成为一种常规手术:本综述基于通过选择性文献检索检索到的有关肺移植的出版物,以及两个大型肺移植中心的程序和经验:结果:肺移植后的平均存活时间为六年,是所有实体器官移植后存活时间最短的。41%的患者在五年后出现慢性移植物功能障碍,这是肺部移植后死亡的主要原因,其次是感染和癌症:结论:尽管肺移植手术取得了长足的进步,但急性移植功能障碍,尤其是慢性移植功能障碍,仍然是大容量移植中心面临的一大挑战。为防止移植物排斥和感染而单独定制的免疫抑制对这些患者的长期生存非常重要。异种移植和所谓的肺生物工程在未来可能成为异种移植的替代方法。
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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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