title: [The management of lung transplantation candidates. A case series].
abstract: BACKGROUND
  Lung transplantation (LT) is associated with an increased risk of infection, cancer, chronic renal failure, cardiovascular disease and osteoporosis. Some risk factors precede transplantation and could benefit for early diagnosis and optimised care.
  
  
  METHODS
  The incidence of comorbidities and their treatment before referral were assessed in 157 consecutive lung transplant candidates between 2008 and 2011.
  
  
  RESULTS
  The median age was 37years [25; 51]. Fifty-six percent had a body mass index below 19kg/m(2). In the COPD group, only 50 % had undergone a pulmonary rehabilitation program in the preceding 2 years. Osteoporosis was present in 42 %, of whom 36 % were on bisphophonate therapy. Vitamin D deficiency was present in 65 %. Previously undiagnosed cardiovascular risk factors were discovered during LT assessment: hypertension in one patient, hypercholesterolemia in 6 % and diabetes in 4 %. Poor dental condition necessitating extractions were found in 41 % of patients. Protective anti-HBs antibodies levels were present in 50 % of the patients at the time of referral.
  
  
  CONCLUSIONS
  The assessment and early treatment of nutritional disorders, osteoporosis and risk factors for infection as well as addressing associated cardiovascular risk factors should be optimised in the care of patients with chronic respiratory insufficiency. The potential for becoming a lung transplant candidate in the future should be kept in mind early in the global management of those patients.
authors.affiliation: Service de pneumologie, hôpital Foch, groupe de transplantation pulmonaire, 40, rue Worth, 92150 Suresnes, France. Electronic address: c.picard@hopital-foch.org.
authors.forename: C
authors.initials: C
authors.lastname: Picard
authors.affiliation: Service de pneumologie, hôpital Foch, groupe de transplantation pulmonaire, 40, rue Worth, 92150 Suresnes, France.
authors.forename: M
authors.initials: M
authors.lastname: Boisseau
authors.affiliation: Service de pneumologie, hôpital Foch, groupe de transplantation pulmonaire, 40, rue Worth, 92150 Suresnes, France.
authors.forename: S
authors.initials: S
authors.lastname: De Miranda
authors.affiliation: Service de pneumologie, hôpital Foch, groupe de transplantation pulmonaire, 40, rue Worth, 92150 Suresnes, France.
authors.forename: A
authors.initials: A
authors.lastname: Hamid
authors.affiliation: Service de pneumologie, hôpital Foch, groupe de transplantation pulmonaire, 40, rue Worth, 92150 Suresnes, France.
authors.forename: D
authors.initials: D
authors.lastname: Grenet
authors.affiliation: Unité de soins intensifs respiratoires, service de chirurgie thoracique, hôpital Foch, groupe de transplantation pulmonaire, 92150 Suresnes, France.
authors.forename: F
authors.initials: F
authors.lastname: Parquin
authors.affiliation: Unité de soins intensifs respiratoires, service de chirurgie thoracique, hôpital Foch, groupe de transplantation pulmonaire, 92150 Suresnes, France.
authors.forename: E
authors.initials: E
authors.lastname: Sage
authors.affiliation: Service de pneumologie, hôpital Foch, groupe de transplantation pulmonaire, 40, rue Worth, 92150 Suresnes, France.
authors.forename: M
authors.initials: M
authors.lastname: Stern
authors.affiliation: Service de pneumologie, hôpital Foch, groupe de transplantation pulmonaire, 40, rue Worth, 92150 Suresnes, France.
authors.forename: A
authors.initials: A
authors.lastname: Roux
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy / Q000453:epidemiology; D016040:Lung Transplantation; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods*; D012131:Respiratory Insufficiency / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D014076:Tooth Diseases / Q000453:epidemiology; D014081:Tooth Extraction
keywords: Chronic respiratory failure; Comorbidities; Comorbidités; Insuffisance respiratoire chronique; Lung transplantation; Nutritional disorders; Osteoporosis; Ostéoporose; Transplantation pulmonaire; Troubles nutritionnels