Pulmonary and Critical Care Medicine, Section of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, WI, USA.
Expert Rev Respir Med. 2008 Apr;2(2):183-99. doi: 10.1586/17476348.2.2.183.
Lung transplant recipients are at risk of numerous complications, which range from early events, such as primary graft dysfunction, to late events, including opportunistic infection or graft loss caused by chronic rejection. Although lung transplantation is often the only therapeutic option that can improve quality of life and prolong survival for many forms of end-stage lung disease, survival following lung transplantation is significantly worse than survival following transplantation of other solid organs. Carefully choosing potential recipients for listing, maximizing the likelihood that donor organs will function well following implantation, appropriate use of immunosuppressive agents to prevent allograft rejection, prophylactic or pre-emptive strategies to prevent allograft infection and appropriate surveillance to detect significant complications are key to maximizing the likelihood of prolonged graft and patient survival while avoiding significant complications following lung transplantation. Post-transplant outcomes will be optimized by a team approach to comprehensive management of the lung transplantation recipient combined with vigilant surveillance to detect complications in a timely fashion.
肺移植受者存在多种并发症的风险,包括早期事件,如原发性移植物功能障碍,以及晚期事件,包括机会性感染或慢性排斥引起的移植物丢失。虽然肺移植通常是改善生活质量和延长许多终末期肺病患者生存时间的唯一治疗选择,但肺移植后的生存率明显低于其他实体器官移植后的生存率。仔细选择有资格进行移植的受者、最大限度地提高供体器官在植入后的功能良好的可能性、适当使用免疫抑制剂来预防同种异体排斥反应、预防性或先发制人的策略来预防同种异体感染以及进行适当的监测以发现严重的并发症,这些都是最大限度地提高移植物和患者生存时间的关键,同时避免肺移植后的严重并发症。通过团队方法对肺移植受者进行全面管理,并及时进行监测以发现并发症,可以优化移植后的结果。