Lung transplantation for cystic fibrosis.
OBJECTIVE
To examine recent publications on lung transplantation for cystic fibrosis for changes in surgical techniques, selection criteria of patients, and impact on quality of life.


RESULTS
Recent evidence focuses on cystic fibrosis patient subsets enabling better decisions about listing for lung transplantation as a therapeutic option. There is information about Burkholderia cepacia infection, ventilator dependence, young age, and arthropathy. In the US, the United Network for Organ Sharing has addressed perceived inequities in organ distribution by allocating organs by illness severity rather than time on the waiting list. A Lung Allocation Score ranks severity for patients 12 years of age and older for transplantation based on variables including lung function, oxygen and ventilatory needs, diabetes, weight and physical performance. Some recently studied important variables that influence survival in cystic fibrosis and after lung transplantation, including airway infections, pancreatic exocrine function and acute exacerbations, are not included in the Lung Allocation Score. Few publications have examined quality of life after transplantation, and a definitive work has yet to appear.


CONCLUSIONS
New information has refined decision-making about lung transplantation for patients with cystic fibrosis. We examine recent findings and make recommendations for patients, families and medical providers.
Liou
Theodore G
TG
Department of Internal Medicine, University of Utah, Salt Lake City, Utah 84132, USA. ted.liou@utah.edu
Woo
Marlyn S
MS
Cahill
Barbara C
BC
D003550:Cystic Fibrosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D016040:Lung Transplantation; D018579:Patient Selection; D011184:Postoperative Period; D011788:Quality of Life; D040841:Resource Allocation; D009927:Tissue and Organ Procurement