Meyer Keith C
UW Lung Transplant & Advanced Pulmonary Disease Program, Section of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health 600 Highland Ave, Madison, WI 53792 USA.
F1000Prime Rep. 2013 May 1;5:16. doi: 10.12703/P5-16. Print 2013.
Lung transplantation may be the only intervention that can prolong survival and improve quality of life for those individuals with advanced lung disease who are acceptable candidates for the procedure. However, these candidates may be extremely ill and require ventilator and/or circulatory support as a bridge to transplantation, and lung transplantation recipients are at risk of numerous post-transplant complications that include surgical complications, primary graft dysfunction, acute rejection, opportunistic infection, and chronic lung allograft dysfunction (CLAD), which may be caused by chronic rejection. Many advances in pre- and post-transplant management have led to improved outcomes over the past decade. These include the creation of sound guidelines for candidate selection, improved surgical techniques, advances in donor lung preservation, an improving ability to suppress and treat allograft rejection, the development of prophylaxis protocols to decrease the incidence of opportunistic infection, more effective therapies for treating infectious complications, and the development of novel therapies to treat and manage CLAD. A major obstacle to prolonged survival beyond the early post-operative time period is the development of bronchiolitis obliterans syndrome (BOS), which is the most common form of CLAD. This manuscript discusses recent and evolving advances in the field of lung transplantation.
肺移植可能是唯一能延长晚期肺病患者生存期并改善其生活质量的干预措施，这些患者是该手术的合适候选者。然而，这些候选者可能病情极其严重，需要呼吸机和/或循环支持作为移植的过渡，而且肺移植受者面临众多移植后并发症的风险，包括手术并发症、原发性移植功能障碍、急性排斥反应、机会性感染以及慢性肺移植功能障碍（CLAD），后者可能由慢性排斥反应引起。在过去十年中，移植前和移植后的管理取得了许多进展，带来了更好的治疗效果。这些进展包括制定完善的候选者选择指南、改进手术技术、供肺保存方面的进展、抑制和治疗移植排斥反应能力的提高、降低机会性感染发生率的预防方案的制定、治疗感染性并发症的更有效疗法以及治疗和管理CLAD的新疗法的开发。术后早期之后延长生存期的一个主要障碍是闭塞性细支气管炎综合征（BOS）的发生，它是CLAD最常见的形式。本文讨论了肺移植领域的最新进展和不断发展的情况。
