Hirdman Gabriel, Niroomand Anna, Olm Franziska, Lindstedt Sandra
Department of Cardiothoracic Surgery and Transplantation, Skåne University Hospital, Lund University, Lund, Sweden.
Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden.
Curr Transplant Rep. 2022;9(3):160-172. doi: 10.1007/s40472-022-00367-0. Epub 2022 May 16.
This article reviews controversial questions within the field of lung transplantation, with a focus on data generated within the last 3 years. We aim to summarize differing opinions on a selection of topics, including bridge-to-transplantation, intraoperative machine circulatory support, bronchial anastomosis, size mismatch, delayed chest closure, and ex vivo lung perfusion.
With the growing rate of lung transplantations worldwide and increasing numbers of patients placed on waiting lists, the importance of determining best practices has only increased in recent years. Factors which promote successful outcomes have been identified across all the topics, with certain approaches promoted, such as ambulation in bridge-to-transplant and widespread intraoperative ECMO as machine support.
While great strides have been made in the operative procedures involved in lung transplantation, there are still key questions to be answered. The consensus which can be reached will be instrumental in further improving outcomes in recipients.
本文回顾了肺移植领域内存在争议的问题,重点关注过去3年产生的数据。我们旨在总结在一系列主题上的不同观点,包括过渡到移植、术中机械循环支持、支气管吻合术、尺寸不匹配、延迟关胸以及体外肺灌注。
随着全球肺移植率的不断上升以及等待名单上患者数量的增加,近年来确定最佳实践的重要性日益凸显。在所有主题中都已确定了促进成功结果的因素,某些方法得到了推广,例如过渡到移植时的活动以及广泛使用术中体外膜肺氧合作为机械支持。
虽然肺移植所涉及的手术程序已取得了巨大进展,但仍有一些关键问题有待解答。达成的共识将有助于进一步改善受者的结局。