[Indications of lung transplantation: Patients selection, timing of listing, and choice of procedure].
Lung transplantation (LT) is now considered as an excellent treatment option for selected patients with end-stage pulmonary diseases, such as COPD, cystic fibrosis, idiopathic pulmonary fibrosis, and pulmonary arterial hypertension. The 2 goals of LT are to provide a survival benefit and to improve quality of life. The 3-step decision process leading to LT is discussed in this review. The first step is the selection of candidates, which requires a careful examination in order to check absolute and relative contraindications. The second step is the timing of listing for LT; it requires the knowledge of disease-specific prognostic factors available in international guidelines, and discussed in this paper. The third step is the choice of procedure: indications of heart-lung, single-lung, and bilateral-lung transplantation are described. In conclusion, this document provides guidelines to help pulmonologists in the referral and selection processes of candidates for transplantation in order to optimize the outcome of LT.
Service de pneumologie, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France. Electronic address: helene.morisse@yahoo.fr.
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Morisse Pradier
Service de pneumologie, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Sénéchal
Service de pneumologie, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Philit
Service de chirurgie thoracique, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Tronc
Service de chirurgie thoracique, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Maury
Service de chirurgie thoracique, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Grima
Département d'anesthésie-réanimation, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Flamens
Département d'anesthésie-réanimation, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Paulus
Département d'anesthésie-réanimation, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Neidecker
Service de pneumologie, hôpital Louis-Pradel, 28, avenue Doyen-Lépine, 69677 Bron cedex, France.
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Mornex
D002755:Choice Behavior; D000075202:Contraindications; D003550:Cystic Fibrosis / Q000628:therapy; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000628:therapy; D016040:Lung Transplantation / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D018579:Patient Selection; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012131:Respiratory Insufficiency / Q000628:therapy; D013997:Time Factors; D014850:Waiting Lists
BPCO; COPD; Critères de sélection; Cystic fibrosis; Fibrose pulmonaire idiopathique; HTAP; Idiopathic pulmonary fibrosis; Lung transplantation; Mucoviscidose; Pulmonary arterial hypertension; Selection criteria; Transplantation pulmonaire