Jenkinson S G, Levine S M
University of Texas Health Science Center at San Antonio.
Dis Mon. 1994 Jan;40(1):1-38. doi: 10.1016/0011-5029(94)90007-8.
Solid-organ transplantation has flourished during the last decade, with transplantation of heart and lungs becoming available to patients with end-stage cardiac or pulmonary diseases. The first lung transplant was performed in 1963 on a 58-year-old man with bronchogenic carcinoma. He survived for 18 days. During the next two decades, approximately 40 lung transplant procedures were attempted without success. These early attempts at lung transplantation were unsuccessful because of the development of lung rejection, anastomotic complications, or infection in the transplant recipients. In the early 1980s, human heart-lung transplantation was successfully performed for the treatment of pulmonary vascular disease. After this procedure, single-lung transplantation for the treatment of end-stage interstitial lung disease and obstructive lung disease was developed. More recently, the technique of double-lung transplantation has come into existence. This article reviews various aspects of lung transplantation, including immunosuppression, lung graft preservation, the various surgical techniques and types of lung transplant procedures available, recipient and donor selection criteria, and postoperative care of the transplant recipient. In addition, infectious and noninfectious complications seen in this particular patient population, including acute and chronic rejection, will be discussed.
在过去十年中，实体器官移植蓬勃发展，终末期心脏或肺部疾病患者已可接受心脏和肺移植。1963年，首例肺移植手术在一名58岁的支气管肺癌男性患者身上进行。他存活了18天。在接下来的二十年里，大约进行了40例肺移植手术，但均未成功。这些早期的肺移植尝试之所以失败，是因为移植受者出现了肺排斥反应、吻合口并发症或感染。20世纪80年代初，人类心肺移植成功用于治疗肺血管疾病。在此之后，单肺移植被开发用于治疗终末期间质性肺病和阻塞性肺病。最近，双肺移植技术应运而生。本文回顾了肺移植的各个方面，包括免疫抑制、肺移植保存、现有的各种手术技术和肺移植手术类型、受者和供者的选择标准以及移植受者的术后护理。此外，还将讨论在这一特定患者群体中出现的感染性和非感染性并发症，包括急性和慢性排斥反应。
