Lung transplantation.
Lung transplantation.
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肺移植。
DOI：
10.1055/s-0033-1348476
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发表时间：
2013
影响因子：
3.2
通讯作者：
Christie,JasonD
中科院分区：
文献类型：
--
作者：
Belperio,JohnA;Christie,JasonD
肺移植对于终末期肺和肺血管疾病患者来说是一种越来越可行的治疗选择。自从第一例肺移植手术开始以来，在临床和基础科学领域都取得了重大进展。更具体地说，肺移植界通过我们对各种肺部疾病的预后进行预测的能力以及通过实施肺分配评分系统，在候选人选择方面取得了进展。该系统降低了肺移植等待名单上患者的死亡率。此外，我们已经确定了肺移植后不良结局的风险因素，更好地了解了原发性移植物功能障碍（PGD）、感染性疾病、急性排斥反应、抗体介导的排斥反应、淋巴细胞性细支气管炎、闭塞性细支气管炎、限制性同种异体移植综合征和慢性肺移植物功能障碍的生理、细胞和分子机制。尽管由于更好的手术技术和重症监护的进步，早期术后生存率有所提高，但严重PGD、感染性疾病（例如细菌、病毒、真菌、分枝杆菌）和同种异体移植物排斥反应仍然是发病率和死亡率的常见原因。因此，有必要扩大我们目前的了解如何PGD，感染，急性和慢性排斥反应相互作用，导致死亡的肺移植。本期《呼吸和重症监护医学研讨会》致力于肺移植，整合了基础和临床科学，提供了全面的视角来确定哪些患者需要肺移植、肺分配评分如何影响美国的移植受者、促成PGD的因素、PGD对死亡率的贡献，以及长期-
Lung transplantation is an increasingly viable therapeutic option for patients with end-stage pulmonary and pulmonary vascular disorders. Since the inception of the first lung transplant there has been substantial progress made in both the clinical and the basic science realms. More specifically, the lung transplant community has made advances in candidate selection via our ability to prognosticate outcomes of various lung diseases and through the implementation of the lung allocation scoring system. This system has resulted in decreased mortality for patients on the lung transplant waiting list. Additionally, we have identified risk factors for poor outcomes post–lung transplant with a better understanding of the physiological, cellular, and molecular mechanisms responsible for primary graft dysfunction (PGD), infectious diseases, acute rejection, antibody-mediated rejection, lymphocytic bronchiolitis, obliterative bronchiolitis, restrictive allograft syndrome, and chronic lung allograft dysfunction. Although early post-survival has improved due to better surgical techniques and advances in critical care, severe PGD, infectious diseases (eg, bacterial, viral, fungal, mycobacterial), and allograft rejection continue to be common causes of morbidity and mortality. Thus there is a need to extend our current understanding of how PGD, infection, and acute and chronic rejection interact leading to the demise of the lung allograft. This issue of Seminars in Respiratory and CriticalCare Medicine is dedicated to lung transplantation and integrates both basic and clinical science, providing a comprehensive perspective on determining which patients need a lung transplant, how the lung allocation score impacts transplant recipients in the United States, factors contributing to PGD, the contribution of PGD to mortality, as well as long-