Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21205, USA.
Curr Opin Pulm Med. 2011 Nov;17(6):467-72. doi: 10.1097/MCP.0b013e32834b8bdb.
This review summarizes recently published investigations on issues pertaining to cystic fibrosis (CF) lung transplantation. We specifically focus on indications and candidate selection as well as infectious and noninfectious issues specific to CF lung transplant recipients.
Recent studies have focused on candidate adequacy in high-risk CF patients. We review the current literature on individuals who develop respiratory failure requiring mechanical ventilation and those patients with a pretransplant diagnosis of pulmonary hypertension. Furthermore, the management of peri-operative infectious issues is reviewed including recurrent infections with multidrug-resistant bacterial, mycobacterial, and fungal organisms. Other CF-specific issues addressed include common comorbidities such as CF-related diabetes, gastroesophageal reflux, CF liver disease, and bone metabolism.
Lung transplantation is a limited, but potentially life-saving therapeutic option for patients with CF. Optimal candidate selection and awareness of CF-specific issues in the pretransplant and posttransplant setting may lead to better long-term outcomes.
本综述总结了最近发表的关于囊性纤维化（CF）肺移植相关问题的研究。我们特别关注适应证和候选者选择，以及 CF 肺移植受者特有的感染和非感染问题。
最近的研究集中在高危 CF 患者的候选者充分性上。我们回顾了目前关于需要机械通气的呼吸衰竭患者和移植前诊断为肺动脉高压的患者的文献。此外，还回顾了围手术期感染问题的处理，包括多药耐药细菌、分枝杆菌和真菌的复发性感染。其他 CF 特有的问题包括常见的合并症，如 CF 相关性糖尿病、胃食管反流、CF 肝疾病和骨代谢。
肺移植是 CF 患者的一种有限但有潜在救命作用的治疗选择。在移植前和移植后阶段，最佳的候选者选择和对 CF 特定问题的认识可能会导致更好的长期结果。
