Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
Semin Respir Crit Care Med. 2018 Apr;39(2):117-125. doi: 10.1055/s-0037-1615796. Epub 2018 Mar 26.
Lung transplantation is a widely accepted treatment to manage the advanced stages of many lung diseases that have failed to respond to all other therapeutic interventions. There have been ever-expanding indications for lung transplantation as a treatment for lung disease. The International Society for Heart and Lung Transplantation (ISHLT) updated guidelines for candidate selection in 2014. This document was published to serve as a guide in selecting appropriate candidates for lung transplantation. Ideal candidates for lung transplantation are those with near-end stage disease, limited life expectancy due to their lung disease, and who experience significant loss in quality of life. At the same time, candidates should be free of significant comorbidities that might negatively impact successful transplantation. Despite well thought out published guidelines for candidate selection, many controversial issues surrounding selection of lung transplant candidates remain. This review will focus on some of the more common controversial issues and explain how most centers approach these issues when choosing candidates for lung transplantation.
肺移植是一种广泛接受的治疗方法，用于治疗许多肺部疾病的晚期阶段，这些疾病对所有其他治疗干预都没有反应。随着肺移植作为肺部疾病治疗方法的应用指征不断扩大，国际心肺移植学会（ISHLT）在 2014 年更新了候选者选择指南。本文件的发布旨在为肺移植的合适候选者选择提供指导。肺移植的理想候选者是那些患有接近终末期疾病、因肺部疾病预期寿命有限且生活质量显著下降的患者。同时，候选者应无可能对成功移植产生负面影响的重大合并症。尽管有深思熟虑的候选者选择发布指南，但围绕肺移植候选者选择的许多有争议的问题仍然存在。本综述将重点介绍一些更常见的有争议的问题，并解释大多数中心在选择肺移植候选者时如何处理这些问题。
