Kim Hyoung Soo, Park Sunghoon
Department of Cardiothoracic Surgery, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
J Chest Surg. 2022 Aug 5;55(4):265-273. doi: 10.5090/jcs.22.042.
Lung transplantation is considered a viable treatment option for patients with end-stage lung disease. Recent decades have seen a gradual increase in the number of lung transplantation patients worldwide, and in South Korea, the case number has increased at least 3-fold during the last decade. Furthermore, the waiting list time is becoming longer, and more elderly patients (>65 years) are undergoing lung transplantation; that is, the patients placed on the waiting list are older and sicker than in the past. Hence, proper management during the pre-transplantation period, as well as careful selection of candidates, is a key factor for transplant success and patient survival. Although referring and transplant centers should address many issues, the main areas of focus should be the timing of referral, nutrition, pulmonary rehabilitation, critical care (including mechanical ventilation and extracorporeal membrane oxygenation), psychological support, and the management of preexisting comorbid conditions (coronary artery disease, diabetes mellitus, gastroesophageal reflux disease, osteoporosis, malignancy, viral infections, and chronic infections). In this context, the present article reviews and summarizes the pre-transplantation management strategies for adult patients listed for lung transplantation.
肺移植被认为是终末期肺病患者可行的治疗选择。近几十年来，全球肺移植患者数量逐渐增加，在韩国，病例数在过去十年中至少增加了三倍。此外，等待名单时间越来越长，越来越多的老年患者（>65岁）正在接受肺移植；也就是说，等待名单上的患者比过去年龄更大、病情更重。因此，移植前期的妥善管理以及仔细筛选候选人是移植成功和患者存活的关键因素。尽管转诊中心和移植中心应解决许多问题，但主要关注领域应是转诊时机、营养、肺康复、重症监护（包括机械通气和体外膜肺氧合）、心理支持以及既往合并症（冠状动脉疾病、糖尿病、胃食管反流病、骨质疏松症、恶性肿瘤、病毒感染和慢性感染）的管理。在此背景下，本文回顾并总结了列入肺移植名单的成年患者的移植前管理策略。
