Higenbottam T, Otulana B A, Wallwork J
Dept of Respiratory Physiology, Papworth Hospital, Cambridge, UK.
Eur Respir J. 1990 May;3(5):594-605.
The introduction of cyclosporine as a highly effective immunosuppressive agent and the development of new techniques for heart-lung and lung transplantation have led to a new treatment for a wide range of fatal cardiopulmonary diseases. Indications for surgery are now becoming clear, together with major contra-indications. Suppurative lung disease, such as cystic fibrosis, can be effectively treated by heart-lung transplant (HLT). A whole new field of pulmonary medicine is emerging to provide the physiological monitoring and diagnostic techniques for major complications such as opportunistic lung infection and pulmonary rejection. Obliterative bronchiolitis, a consequence of frequent and severe rejection, still provides a major challenge to the immunological scientist and respiratory physician. Lung transplantation, by disrupting the vascular supply and innervation of the lung, is raising major questions about the generally accepted beliefs of regulation of breathing and pulmonary mechanics. Finally, as the survival rate improves beyond the current 50% at 3 yrs, lung transplantation will perhaps present further challenges to our understanding of the pathogenesis of various diseases such as asthma and cystic fibrosis.
环孢素作为一种高效免疫抑制剂的引入以及心肺和肺移植新技术的发展，为多种致命性心肺疾病带来了新的治疗方法。手术适应症以及主要禁忌症如今正逐渐明确。化脓性肺部疾病，如囊性纤维化，可通过心肺移植（HLT）得到有效治疗。一个全新的肺部医学领域正在兴起，以提供针对诸如机会性肺部感染和肺排斥等主要并发症的生理监测和诊断技术。闭塞性细支气管炎，作为频繁且严重排斥反应的后果，仍然给免疫学家和呼吸内科医生带来重大挑战。肺移植通过扰乱肺的血管供应和神经支配，正在对呼吸调节和肺力学的普遍公认观念提出重大质疑。最后，随着3年生存率超过目前的50%，肺移植可能会对我们对哮喘和囊性纤维化等各种疾病发病机制的理解提出进一步挑战。
