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肺结节病的肺移植

Lung transplantation for pulmonary sarcoidosis.

作者信息

Meyer Keith C

机构信息

Department of Medicine, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2019;36(2):92-107. doi: 10.36141/svdld.v36i2.7163. Epub 2019 May 1.

Abstract

Although relatively few patients with pulmonary sarcoidosis develop advanced disease that progresses to respiratory insufficiency despite receiving best practice pharmacologic interventions, lung transplantation may be the only therapeutic option for such patients to both prolong survival and provide improved quality of life. Lung transplant can be successfully performed for patients with end-stage pulmonary sarcoidosis, and post-transplant survival is similar to that for other transplant indications such as idiopathic pulmonary fibrosis. However, appropriate timing of referral, comprehensive assessment of potential candidates for lung transplant, placement of patients on the lung transplant waiting list when within the transplant window as appropriate, choosing the best procedure (bilateral versus single lung transplant), and optimal peri-operative and post-transplant management are key to successful lung transplant outcomes for patients with sarcoidosis.

摘要

尽管相对较少的肺结节病患者在接受最佳实践药物干预后仍会发展为进展至呼吸功能不全的晚期疾病,但肺移植可能是此类患者延长生存期并改善生活质量的唯一治疗选择。对于终末期肺结节病患者可以成功进行肺移植,移植后的生存率与特发性肺纤维化等其他移植适应症相似。然而,合适的转诊时机、对肺移植潜在候选者的全面评估、在合适的移植窗口期将患者列入肺移植等待名单、选择最佳手术方式(双侧肺移植与单肺移植)以及优化围手术期和移植后的管理,是肺结节病患者肺移植成功的关键。

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