Stern M, Reynaud-Gaubert M, Haloun A, Bertocchi M, Grenet D
Service de pneumologie, Hôpital Foch, Suresnes. stern.houssaye@wana doo.fr
Rev Mal Respir. 2000 Aug;17(3 Pt 2):779-84.
Lung transplantation (LT) became during the ten past years an important therapeutic option for cystic fibrosis adult patients with end-stage chronic lung disease. LT clearly improves both survival and long term quality of life. A rigorous selection of the candidates is of paramount importance to improve the results of LT because of the lack of shortage of organs. This selection requires a multidisciplinary assessment to refuse patients with absolute exclusion criteria or general medical conditions that impact negatively on short- and long-term outcome. One of the major difficulties is to determine the best time to refer patients to transplantation, arguing the comparison between the predicted survival time of the candidate, under optimal medical therapy, with or without LT. The selection period is also an active process to prepare the patients to the postoperative follow-up and includes a nutritional and rehabilitation program with an educational and psychological preparation. The aim of the present work is to gather the worldwide principles of the selection of the CF patients for LT, commonly used by the LT centers. These recommendations should provide the CF center practitioners with the main elements to prepare their patients to an LT project before a relentless end-stage clinical condition.
在过去十年中，肺移植（LT）已成为患有终末期慢性肺病的成年囊性纤维化患者的重要治疗选择。肺移植明显提高了生存率和长期生活质量。由于器官短缺，对候选者进行严格筛选对于提高肺移植的效果至关重要。这种筛选需要进行多学科评估，以拒绝具有绝对排除标准或对短期和长期结果有负面影响的一般医疗状况的患者。其中一个主要困难是确定将患者转诊至移植的最佳时间，这需要比较候选者在接受或不接受肺移植的最佳药物治疗下的预测生存时间。筛选期也是一个让患者为术后随访做准备的积极过程，包括营养和康复计划以及教育和心理准备。本研究的目的是收集肺移植中心普遍采用的全球范围内囊性纤维化患者肺移植筛选原则。这些建议应能为囊性纤维化中心的从业者提供主要要素，以便在患者病情发展到不可逆转的终末期临床状况之前，为他们的肺移植项目做好准备。
