Lung transplantation for chronic obstructive pulmonary disease: past, present, and future directions.
Lung transplantation for chronic obstructive pulmonary disease: past, present, and future directions.
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DOI：
10.1097/mcp.0000000000000452
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发表时间：
2018-03
影响因子：
3.3
通讯作者：
Diamond JM
中科院分区：
文献类型：
--
作者：
Siddiqui FM;Diamond JM
肺移植为终末期慢性阻塞性肺疾病(COPD)患者提供了一种有效的治疗方式。关于何时转介、列出和提供移植的确切决定，以及首选的移植程序类型仍不清楚。此外，考虑进行肺移植的COPD患者也有特殊的考虑因素，包括单肺移植对肺癌风险、自然肺过度膨胀和总存活率的影响。国际心肺移植学会最新的建议依赖于基于BODE指数的COPD严重程度评估。尽管缺乏证据支持双侧肺移植比单肺移植对COPD患者的死亡率有好处，但在这一人群中进行的大多数移植仍然是双侧的。单肺移植的一些特殊问题仍然是新发的自然肺癌的可能性，以及急性自然肺过度膨胀的血流动力学和生理学影响。COPD仍然是全球范围内肺移植最常见的适应症。仍需要进行研究来评估肺移植的总体生存益处，以及评估对COPD患者群体的总体生活质量的影响。
Lung transplantation offers an effective treatment modality for patients with end-stage chronic obstructive pulmonary disease (COPD). The exact determination of when to refer, list and offer transplant as well as the preferred transplant procedure type remains unclear. Additionally, there are special considerations specific to patients with COPD being considered for lung transplantation, including the implications of single lung transplantation on lung cancer risk, native lung hyperinflation, and overall survival. The International Society for Heart and Lung Transplantation most recent recommendations rely on an assessment of COPD severity based on BODE index. Despite the lack of evidence supporting a mortality benefit of bilateral over single lung transplantation for COPD patients, the majority of transplants performed in this population remain bilateral. Some of the concerns specific to single lung transplantation remain the possibility of de novo native lung cancer and the hemodynamic and physiologic implications of acute native lung hyperinflation. COPD remains the most common worldwide indication for lung transplantation. Ongoing study is still required to assess the overall survival benefit of lung transplantation and assess the overall quality of life impact on the COPD patient population.