Cremona G, Higenbottam T, Wallwork J
Department of Respiratory Physiology, Papworth Hospital, Cambridge, UK.
Respiration. 1991;58 Suppl 1:22-9. doi: 10.1159/000195966.
The last decade has seen lung and heart-lung transplantation move from experimental procedures to clinical treatments. Innovative surgical techniques combined with the use of ciclosporin as an immunosuppressive agent have enabled successful transplantation in a wide range of end-stage lung diseases. Exclusion criteria for selecting recipients have relaxed, and improved preservation techniques have facilitated distant donor organ procurement and decreased peri-operative mortality. A range of techniques for the physiological monitoring of the graft as well as diagnosis of major complications such as rejection and opportunistic infection have been introduced. Obliterative bronchiolitis remains a major challenge to the immunologist and to the chest physician in terms of etiology, pathogenesis and treatment. As survival rates improve with improved management, lung and heart-lung transplantations are contributing towards effective treatment of end-stage pulmonary disease as well as providing new insight into pulmonary physiology and into mechanisms of lung disease.
在过去十年中，肺移植和心肺移植已从实验性手术发展为临床治疗手段。创新的外科技术与环孢素作为免疫抑制剂的使用相结合，使得在多种终末期肺部疾病中成功进行移植成为可能。选择受者的排除标准已经放宽，改进的保存技术促进了远距离供体器官的获取，并降低了围手术期死亡率。已经引入了一系列用于监测移植物生理状况以及诊断诸如排斥反应和机会性感染等主要并发症的技术。闭塞性细支气管炎在病因、发病机制和治疗方面仍然是免疫学家和胸科医生面临的主要挑战。随着管理的改善生存率提高，肺移植和心肺移植有助于终末期肺部疾病的有效治疗，同时也为肺生理学和肺部疾病机制提供了新的见解。
