Department of Chest Medicine, University Hospital, Brussels, Belgium.
Curr Opin Organ Transplant. 2009 Oct;14(5):466-70. doi: 10.1097/MOT.0b013e3283303607.
The present review provides an update on the recent literature regarding disease-specific issues in lung transplantation. Some of the published data will help refine previously published candidate selection criteria and provide evidence-based data for choice of procedures.
Recent studies on lung transplant outcomes in older patients underline that satisfactory results can be obtained in patients older than 60 years but not in patients older than 70 years. Data from two large registry-based studies indicate that bilateral lung transplantation in patients with chronic obstructive pulmonary disease confers significantly longer survival than single lung transplantation, especially in patients younger than 60 years. Mathematical models to estimate survival benefit in chronic obstructive pulmonary disease lung transplant candidates have been developed and are being validated. The impact of Bcc colonization in cystic fibrosis patients on outcome has been nuanced; thus, cystic fibrosis lung transplant candidates colonized by particular Bcc strains may be transplanted with good outcomes. Novel surgical approaches to peculiar situations in end-stage cystic fibrosis have been described. Candidate selection criteria for retransplantation procedures have further been clarified.
This article attempts to provide an overview of some of the currently important topics for clinicians involved in referring and evaluating patients with end-stage lung disease for lung transplantation in 2009.
本文就肺移植中一些特定疾病的最新文献进行了综述。部分已发表的数据将有助于完善之前的候选者选择标准，并为手术选择提供循证数据。
最近关于老年肺移植患者的研究结果强调，60 岁以上患者可以获得满意的结果，但 70 岁以上患者不行。来自两项大型注册研究的数据表明，慢性阻塞性肺疾病患者行双侧肺移植比单肺移植的存活率显著延长，尤其是 60 岁以下的患者。已经开发并正在验证用于估计慢性阻塞性肺疾病肺移植候选者生存获益的数学模型。Bcc 定植对囊性纤维化患者结局的影响已得到阐明；因此，移植特定 Bcc 株定植的囊性纤维化肺移植候选者可能会有良好的结局。针对终末期囊性纤维化的特殊情况的新型手术方法已经被描述。再次移植手术的候选者选择标准也进一步得到了明确。
本文旨在概述 2009 年与肺移植相关的一些特定疾病的重要临床课题，为涉及肺移植患者转介和评估的临床医生提供参考。
