Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Curr Opin Pulm Med. 2011 May;17(3):206-9. doi: 10.1097/MCP.0b013e328344dba5.
Lung transplantation is an important therapeutic treatment for many patients with life-threatening pulmonary diseases; however, long-term survival is still relatively limited compared with other solid organ transplants. Over the last year, several articles have been published helping to increase our knowledge of infections in lung transplant recipients. In particular, important new information has been published recently regarding cytomegalovirus (CMV) and fungal infections following lung transplantation.
Recent studies indicate prolonged (≥12 months) antiviral prophylaxis for CMV after lung transplant may be beneficial in high-risk transplant recipients. Epidemiologic studies show invasive fungal infections are increasingly being recognized following solid organ transplantation, particularly with Aspergillus and Candida species. Pulmonary infections with CMV and Aspergillus are likely contributors to the development of bronchiolitis obliterans syndrome (BOS).
Lung transplantation has many potential posttransplant complications with infection being a major contributor. More information has become available regarding CMV prophylaxis, CMV treatment, pulmonary fungal infection epidemiology, and the role of both CMV and Aspergillus on the development of BOS, which helps toward the goal of increasing long-term survival in lung transplant recipients.
肺移植是治疗许多危及生命的肺部疾病患者的重要治疗手段;然而,与其他实体器官移植相比,长期存活率仍然相对有限。在过去的一年中,发表了几篇文章,帮助我们增加了对肺移植受者感染的认识。特别是,最近发表了一些关于肺移植后巨细胞病毒(CMV)和真菌感染的重要新信息。
最近的研究表明,肺移植后延长(≥12 个月)CMV 抗病毒预防可能对高危移植受者有益。流行病学研究表明,实体器官移植后侵袭性真菌感染越来越常见,尤其是曲霉菌和假丝酵母菌。CMV 和曲霉菌引起的肺部感染可能是闭塞性细支气管炎综合征(BOS)发展的原因。
肺移植有许多潜在的移植后并发症,感染是主要原因之一。关于 CMV 预防、CMV 治疗、肺部真菌感染流行病学以及 CMV 和曲霉菌在 BOS 发展中的作用的信息越来越多,有助于提高肺移植受者的长期存活率。