Lung transplantation for cystic fibrosis.
Lung transplantation is a complex, high-risk, potentially life-saving therapy for the end-stage lung disease of cystic fibrosis (CF). The decision to pursue transplantation involves comparing the likelihood of survival with and without transplantation as well as assessing the effect of wait-listing and transplantation on the patient's quality of life. Although recent population-based analyses of the US lung allocation system for the CF population have raised controversies about the survival benefits of transplantation, studies from the United Kingdom and Canada have suggested a definite survival advantage for those receiving transplants. In response to these and other controversies, leaders in transplantation and CF met together in Lansdowne, Virginia, to consider the state of the art in lung transplantation for CF in an international context, focusing on advances in surgical technique, measurement of outcomes, use of prognostic criteria, variations in local control over listing, and prioritization among the United States, Canada, the United Kingdom, and The Netherlands, patient adherence before and after transplantation and other issues in the broader context of lung transplantation. Finally, the conference members carefully considered how efforts to improve outcomes for lung transplantation for CF lung disease might best be studied. This Roundtable seeks to communicate the substance of our discussions.
Adler
Frederick R
FR
Department of Mathematics, University of Utah, Salt Lake City, Utah 84112, USA.
Aurora
Paul
P
Barker
David H
DH
Barr
Mark L
ML
Blackwell
Laura S
LS
Bosma
Otto H
OH
Brown
Samuel
S
Cox
D R
DR
Jensen
Judy L
JL
Kurland
Geoffrey
G
Nossent
George D
GD
Quittner
Alexandra L
AL
Robinson
Walter M
WM
Romero
Sandy L
SL
Spencer
Helen
H
Sweet
Stuart C
SC
van der Bij
Wim
W
Vermeulen
J
J
Verschuuren
Erik A M
EA
Vrijlandt
Elianne J L E
EJ
Walsh
William
W
Woo
Marlyn S
MS
Liou
Theodore G
TG
D002648:Child; D003550:Cystic Fibrosis / Q000601:surgery*; D006801:Humans; D016040:Lung Transplantation