Transplantation for end-stage lung disease.
The last decade has seen lung and heart-lung transplantation move from experimental procedures to clinical treatments. Innovative surgical techniques combined with the use of ciclosporin as an immunosuppressive agent have enabled successful transplantation in a wide range of end-stage lung diseases. Exclusion criteria for selecting recipients have relaxed, and improved preservation techniques have facilitated distant donor organ procurement and decreased peri-operative mortality. A range of techniques for the physiological monitoring of the graft as well as diagnosis of major complications such as rejection and opportunistic infection have been introduced. Obliterative bronchiolitis remains a major challenge to the immunologist and to the chest physician in terms of etiology, pathogenesis and treatment. As survival rates improve with improved management, lung and heart-lung transplantations are contributing towards effective treatment of end-stage pulmonary disease as well as providing new insight into pulmonary physiology and into mechanisms of lung disease.
Cremona
G
G
Department of Respiratory Physiology, Papworth Hospital, Cambridge, UK.
Higenbottam
T
T
Wallwork
J
J
D001989:Bronchiolitis Obliterans / Q000209:etiology; D006084:Graft Rejection; D016041:Heart-Lung Transplantation; D006801:Humans; D007239:Infections / Q000209:etiology; D008171:Lung Diseases / Q000601:surgery*; D016040:Lung Transplantation; D011182:Postoperative Care; D011183:Postoperative Complications; D011300:Preoperative Care; D014019:Tissue Donors