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The Journal of Heart and Lung... Nov 2021Tens of thousands of patients with advanced lung diseases may be eligible to be considered as potential candidates for lung transplant around the world each year. The...
Tens of thousands of patients with advanced lung diseases may be eligible to be considered as potential candidates for lung transplant around the world each year. The timing of referral, evaluation, determination of candidacy, and listing of candidates continues to pose challenges and even ethical dilemmas. To address these challenges, the International Society for Heart and Lung Transplantation appointed an international group of members to review the literature, to consider recent advances in the management of advanced lung diseases, and to update prior consensus documents on the selection of lung transplant candidates. The purpose of this updated consensus document is to assist providers throughout the world who are caring for patients with pulmonary disease to identify potential candidates for lung transplant, to optimize the timing of the referral of these patients to lung transplant centers, and to provide transplant centers with a framework for evaluating and selecting candidates. In addition to addressing general considerations and providing disease specific recommendations for referral and listing, this updated consensus document includes an ethical framework, a recognition of the variability in acceptance of risk between transplant centers, and establishes a system to account for how a combination of risk factors may be taken into consideration in candidate selection for lung transplantation.
Topics: Consensus; Contraindications; Cystic Fibrosis; Humans; Lung Transplantation; Patient Selection; Pulmonary Disease, Chronic Obstructive; Societies, Medical
PubMed: 34419372
DOI: 10.1016/j.healun.2021.07.005 -
European Respiratory Review : An... Sep 2019Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease, characterised by progressive scarring of the lung and associated with... (Review)
Review
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease, characterised by progressive scarring of the lung and associated with a high burden of disease and early death. The pathophysiological understanding, clinical diagnostics and therapy of IPF have significantly evolved in recent years. While the recent introduction of the two antifibrotic drugs pirfenidone and nintedanib led to a significant reduction in lung function decline, there is still no cure for IPF; thus, new therapeutic approaches are needed. Currently, several clinical phase I-III trials are focusing on novel therapeutic targets. Furthermore, new approaches in nonpharmacological treatments in palliative care, pulmonary rehabilitation, lung transplantation, management of comorbidities and acute exacerbations aim to improve symptom control and quality of life. Here we summarise new therapeutic attempts and potential future approaches to treat this devastating disease.
Topics: Animals; Comorbidity; Disease Progression; Humans; Idiopathic Pulmonary Fibrosis; Indoles; Lung; Lung Transplantation; Molecular Targeted Therapy; Palliative Care; Pyridones; Respiratory System Agents; Respiratory Therapy; Risk Factors; Treatment Outcome
PubMed: 31484664
DOI: 10.1183/16000617.0021-2019 -
European Respiratory Review : An... Dec 2020Exercise intolerance and impaired quality of life (QoL) are characteristic of lung transplant candidates and recipients. This review investigated the effects of exercise... (Review)
Review
Exercise intolerance and impaired quality of life (QoL) are characteristic of lung transplant candidates and recipients. This review investigated the effects of exercise training on exercise capacity, QoL and clinical outcomes in pre- and post-operative lung transplant patients.A systematic literature search of PubMed, Nursing and Allied Health, Cochrane (CENTRAL), Scopus and CINAHL databases was conducted from inception until February, 2020. The inclusion criteria were assessment of the impact of exercise training before or after lung transplantation on exercise capacity, QoL or clinical outcomes.21 studies met the inclusion criteria, comprising 1488 lung transplant candidates and 1108 recipients. Studies consisted of five RCTs, two quasi-experimental and 14 single-arm cohort or pilot studies. Exercise training improved or at least maintained exercise capacity and QoL before and after lung transplantation. The impact on clinical outcomes was less clear but suggested a survival benefit. The quality of evidence ranged from fair to excellent.Exercise training appears to be beneficial for patients before and after lung transplantation; however, the evidence for direct causation is limited by the lack of controlled trials. Well-designed RCTs are needed, as well as further research into the effect of exercise training on important post-transplant clinical outcomes, such as time to discharge, rejection, infection, survival and re-hospitalisation.
Topics: Exercise; Exercise Therapy; Exercise Tolerance; Humans; Lung Transplantation; Quality of Life
PubMed: 33115788
DOI: 10.1183/16000617.0053-2020 -
Cells Mar 2023Nowadays, lung transplantation is a clinical reality for the treatment of benign end-stage respiratory diseases [...].
Nowadays, lung transplantation is a clinical reality for the treatment of benign end-stage respiratory diseases [...].
Topics: Lung Transplantation; Humans
PubMed: 36980264
DOI: 10.3390/cells12060923 -
The European Respiratory Journal Nov 2019
Topics: Allografts; Humans; Lung Transplantation; Phenotype; Tissue Donors; Transplantation, Homologous
PubMed: 31699784
DOI: 10.1183/13993003.01937-2019 -
The Journal of Heart and Lung... Oct 2022
The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-ninth adult lung transplantation report-2022; focus on lung transplant recipients with chronic obstructive pulmonary disease.
Topics: Adult; Heart Transplantation; Heart-Lung Transplantation; Humans; Lung; Lung Transplantation; Organ Transplantation; Pulmonary Disease, Chronic Obstructive; Registries; Transplant Recipients
PubMed: 36050206
DOI: 10.1016/j.healun.2022.08.007 -
The Journal of Heart and Lung... Oct 2019
The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult lung and heart-lung transplantation Report-2019; Focus theme: Donor and recipient size match.
Topics: Adult; Aged; Annual Reports as Topic; Donor Selection; Female; Heart; Heart-Lung Transplantation; Humans; International Cooperation; Lung; Lung Transplantation; Male; Middle Aged; Organ Size; Patient Selection; Postoperative Complications; Registries; Societies, Medical; Treatment Outcome
PubMed: 31548030
DOI: 10.1016/j.healun.2019.08.001 -
Transplant International : Official... Jan 2020Chronic lung allograft dysfunction (CLAD) comprises both bronchiolitis obliterans syndrome and restrictive allograft syndrome as subtypes. After lung transplantation,... (Review)
Review
Chronic lung allograft dysfunction (CLAD) comprises both bronchiolitis obliterans syndrome and restrictive allograft syndrome as subtypes. After lung transplantation, CLAD remains a major limitation for long-term survival, and lung transplant recipients therefore have poorer outcomes compared with recipients of other solid organ transplants. Although the number of lung transplants continues to increase globally, the field demands detailed understanding of immunoregulatory mechanisms and more effective individualized therapies to combat CLAD. Emerging evidence suggests that CLAD is multifactorial and involves a complex, delicate interplay of multiple factors, including perioperative donor characteristics, inflammation induced immediately following transplant, post-transplant infection and interplay between allo- and autoimmunity directed to donor antigens. Recently, identification of stress-induced exosome release from the transplanted organ has emerged as an underlying mechanism in the development of chronic rejection and promises to prompt novel strategies for future therapeutic interventions. In this review, we will discuss recent studies and ongoing research into the mechanisms for the development of CLAD, with emphasis on immune responses to lung-associated self-antigens-that is, autoimmunity.
Topics: Autoantibodies; Autoimmunity; Bronchiolitis Obliterans; Graft Rejection; Humans; Lung; Lung Transplantation
PubMed: 31393646
DOI: 10.1111/tri.13487 -
Current Opinion in Organ Transplantation Jun 2019Lung transplantation has become an accepted therapy in infants, children, and adolescents suffering from end-stage lung diseases, an impaired quality of life and reduced... (Review)
Review
PURPOSE OF REVIEW
Lung transplantation has become an accepted therapy in infants, children, and adolescents suffering from end-stage lung diseases, an impaired quality of life and reduced life expectancy. The aim of this review is to highlight specific aspects of pediatric lung transplantation and to give an update on recent findings.
RECENT FINDINGS
Currently, over 100 lung transplant procedures are performed in children annually worldwide. Long-term success is limited by availability of donor organs and waitlist mortality pretransplant, and an increased infection risk because of immunosuppression, and most importantly late complications, such as chronic lung allograft dysfunction, medication nonadherence, and transition intricacies.
SUMMARY
Specific aspects of pediatric lung transplantation will be reviewed and an update on most recent developments in the management of pediatric lung transplant recipients given.
Topics: Adolescent; Child; Humans; Infant; Lung Transplantation; Quality of Life
PubMed: 31090643
DOI: 10.1097/MOT.0000000000000630 -
The Journal of Heart and Lung... Oct 2022
The International thoracic organ transplant registry of the international society for heart and lung transplantation: Thirty-ninth adult heart transplantation report-2022; focus on transplant for restrictive heart disease.
Topics: Adult; Heart Diseases; Heart Transplantation; Heart-Lung Transplantation; Humans; Lung Transplantation; Organ Transplantation; Registries; Societies, Medical; Survival Rate
PubMed: 36031520
DOI: 10.1016/j.healun.2022.07.018