A consensus document for the selection of lung transplant candidates: 2014-An update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation
A consensus document for the selection of lung transplant candidates: 2014-An update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation
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DOI：
10.1016/j.healun.2014.06.014
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发表时间：
2015-01-01
影响因子：
8.9
通讯作者：
Glanville, Allan R.
中科院分区：
文献类型：
--
作者：
Weill, David;Benden, Christian;Glanville, Allan R.
选择合适的肺移植受者是决定结果的重要因素。这份共识文件是对2006年发布的受者选择指南的更新。国际心肺移植学会(ISHLT)的肺理事会组织了一个由国际专家组成的撰写委员会，就肺移植候选人的适当转介和名单提供协商一致的意见。在医学图书馆员的协助下，对医学文献进行了全面的搜索。写作委员会成员被分配到特定的主题进行研究和讨论。写作委员会主席负责评估文献检索的完整性，为手稿提供编辑支持，并组织小组讨论其内容。协商一致文件就转介和列入肺移植的时间提出了具体建议。这些建议包括以前ISHLT中没有的讨论，指南，包括肺分配评分，桥接到机械循环和呼吸机支持下的移植，以及扩大肺移植的适应症。在缺乏支持决策的高级证据的情况下，这些共识指南仍然是基于现有研究和个人经验的专家意见连续体的一部分。有些立场是一成不变的。虽然移植是终末期肺部疾病的最后手段，但及早转诊可以进行适当的评估和彻底的患者教育。随后的等待名单激活意味着一种默契，即移植提供了显着的个体生存优势。确保器官分配最大限度地利用稀缺资源的潜在利益，从而实现这一优势，这既是全球移植界的挑战，也是全球移植界的责任。(C)2015年国际心肺移植学会。版权所有。
The appropriate selection of lung transplant recipients is an important determinant of outcomes. This consensus document is an update of the recipient selection guidelines published in 2006.The Pulmonary Council of the International Society for Heart and Lung Transplantation (ISHLT) organized a Writing Committee of international experts to provide consensus opinion regarding the appropriate timing of referral and listing of candidates for lung transplantation. A comprehensive search of the medical literature was conducted with the assistance of a medical librarian. Writing Committee members were assigned specific topics to research and discuss. The Chairs of the Writing Committee were responsible for evaluating the completeness of the literature search, providing editorial support for the manuscript, and organizing group discussions regarding its content.The consensus document makes specific recommendations regarding the timing of referral and of listing for lung transplantation. These recommendations include discussions not present in previous ISHLT, guidelines, including lung allocation scores, bridging to transplant with mechanical circulatory and ventilator support, and expanded indications for lung transplantation.In the absence of high-grade evidence to support decision making, these consensus guidelines remain part of a continuum of expert opinion based on available studies and personal experience. Some positions are immutable. Although transplant is rightly a treatment of last resort for end-stage lung disease, early referral allows proper evaluation and thorough patient education. Subsequent waiting list activation implies a tacit agreement that transplant offers a significant individual survival advantage. It is both the challenge and the responsibility of the transplant community globally to ensure organ allocation maximizes the potential benefits of a scarce resource, thereby achieving that advantage. (C) 2015 International Society for Heart and Lung Transplantation. All rights reserved.