Kolaitis Nicholas A
Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, CA.
Chest. 2023 Oct;164(4):992-1006. doi: 10.1016/j.chest.2023.04.047. Epub 2023 May 5.
Even though patients with pulmonary arterial hypertension have multiple therapeutic options, the disease can be refractory despite appropriate management. In patients with end-stage pulmonary arterial hypertension, lung transplantation has the potential both to extend survival and improve health-related quality of life. Pulmonary arterial hypertension is the only major diagnostic indication for transplantation that is not a parenchymal pulmonary process, and thus the care of these patients is unique.
This review focuses on the complexities of lung transplantation for patients with pulmonary arterial hypertension, presents the updated referral and listing criteria, and discusses the inequities in the organ allocation process that impact this disease group and the strategies to optimize outcomes for patients with pulmonary arterial hypertension who require lung transplantation.
Lung transplantation is an effective and lifesaving therapy for patients with end-stage lung disease. Sadly, patients with pulmonary arterial hypertension face many challenges as it relates to transplantation including higher perioperative risks, inequities in the allocation system, and less favorable long-term outcomes. This review covers the complexities of transplantation in patients with pulmonary vascular disease.
尽管肺动脉高压患者有多种治疗选择，但尽管进行了适当管理，该疾病仍可能难治。在终末期肺动脉高压患者中，肺移植有可能延长生存期并改善健康相关生活质量。肺动脉高压是移植的唯一主要诊断指征，且不是实质性肺部疾病，因此对这些患者的护理独具特色。
本综述聚焦于肺动脉高压患者肺移植的复杂性，呈现更新后的转诊和列入标准，并讨论器官分配过程中影响该疾病群体的不公平现象，以及优化需要肺移植的肺动脉高压患者治疗效果的策略。
肺移植是终末期肺病患者的一种有效且挽救生命的治疗方法。遗憾的是，肺动脉高压患者在移植方面面临诸多挑战，包括围手术期风险更高、分配系统不公平以及长期预后较差。本综述涵盖了肺血管疾病患者移植的复杂性。
