Pulmonary and Critical Care Medicine, UT Southwestern Medical Center, Dallas, TX, USA
Dept of Respiratory Medicine, Hannover Medical School and German Centre for Lung Research, Hannover, Germany.
Eur Respir Rev. 2017 Dec 20;26(146). doi: 10.1183/16000617.0089-2017. Print 2017 Dec 31.
The development of targeted therapies has transformed the outlook for patients with pulmonary arterial hypertension (PAH); however, some patients fail to achieve an adequate clinical response despite receiving maximal treatment. For these patients, lung transplantation remains an important therapeutic option, and recommendations for transplantation are included in the current European Society of Cardiology/European Respiratory Society guidelines for the diagnosis and treatment of pulmonary hypertension. Although lung transplantation is not without risk, overall long-term survival rates are good and substantial improvements in quality of life have been reported for lung transplant recipients. In this review, we describe the important considerations prior to, during and after transplantation, including the role of mechanical support, in patients with advanced PAH.
靶向治疗的发展改变了肺动脉高压（PAH）患者的预后；然而，尽管接受了最大治疗，仍有部分患者未能获得足够的临床反应。对于这些患者，肺移植仍然是一个重要的治疗选择，目前欧洲心脏病学会/欧洲呼吸学会关于肺动脉高压的诊断和治疗指南中包括了肺移植的推荐。虽然肺移植并非没有风险，但总体长期生存率良好，并且肺移植受者的生活质量得到了显著改善。在这篇综述中，我们描述了在晚期 PAH 患者中，移植前、移植中和移植后的重要注意事项，包括机械支持的作用。
