Department of Mathematics, University of Utah, Salt Lake City, Utah 84112, USA.
Proc Am Thorac Soc. 2009 Dec;6(8):619-33. doi: 10.1513/pats.2009008-088TL.
Lung transplantation is a complex, high-risk, potentially life-saving therapy for the end-stage lung disease of cystic fibrosis (CF). The decision to pursue transplantation involves comparing the likelihood of survival with and without transplantation as well as assessing the effect of wait-listing and transplantation on the patient's quality of life. Although recent population-based analyses of the US lung allocation system for the CF population have raised controversies about the survival benefits of transplantation, studies from the United Kingdom and Canada have suggested a definite survival advantage for those receiving transplants. In response to these and other controversies, leaders in transplantation and CF met together in Lansdowne, Virginia, to consider the state of the art in lung transplantation for CF in an international context, focusing on advances in surgical technique, measurement of outcomes, use of prognostic criteria, variations in local control over listing, and prioritization among the United States, Canada, the United Kingdom, and The Netherlands, patient adherence before and after transplantation and other issues in the broader context of lung transplantation. Finally, the conference members carefully considered how efforts to improve outcomes for lung transplantation for CF lung disease might best be studied. This Roundtable seeks to communicate the substance of our discussions.
肺移植是治疗囊性纤维化（CF）终末期肺病的一种复杂、高风险、潜在救生的治疗方法。是否进行移植的决定涉及到比较移植前后的生存率，以及评估等待移植和移植对患者生活质量的影响。尽管最近美国肺分配系统针对 CF 人群的基于人群的分析对移植的生存获益提出了争议，但来自英国和加拿大的研究表明，接受移植的患者确实具有明显的生存优势。针对这些和其他争议，移植和 CF 领域的领导者在弗吉尼亚州兰斯顿举行会议，从国际视角考虑 CF 肺移植的最新技术，重点讨论手术技术的进步、结果测量、预后标准的使用、列出清单的地方控制差异，以及美国、加拿大、英国和荷兰之间的优先级排序、移植前后患者的依从性以及肺移植更广泛背景下的其他问题。最后，会议成员仔细考虑了如何最好地研究改善 CF 肺疾病肺移植结果的努力。本次圆桌会议旨在交流我们讨论的实质内容。
