Indications, patient selection and timing of referral for lung transplantation
Indications, patient selection and timing of referral for lung transplantation
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DOI：
10.1183/09031936.03.00039003
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发表时间：
2003-11-01
影响因子：
24.3
通讯作者：
Estenne, M
中科院分区：
文献类型：
--
作者：
Glanville, AR;Estenne, M
肺移植（LTx）现在被普遍接受为患有严重危及生命的呼吸系统疾病的患者的有用的护理方式，所述严重危及生命的呼吸系统疾病是其他内科或外科治疗难治的。随着LTx在过去15年的巨大发展，潜在受体数量与可用供体器官数量之间的差距已成为一个主要制约因素，许多患者在等待名单上死亡。因此，通过权衡个体患者移植的风险和益处来控制和优化这一有限器官资源的使用，并确定那些有更好机会获得移植良好结局的患者是至关重要的。本文讨论了潜在候选人的选择过程以及目前公认的绝对和相对禁忌症，并提出了一般和疾病的具体建议，以优化转诊的时间。早期转诊考虑肺移植是非常可取的，因为它提高了患者存活移植的机会，并允许移植团队在等待期间积极管理已确定的合并症。
Lung transplantation (LTx) is now generally accepted as a useful modality of care for patients with severe life-threatening respiratory diseases that are refractory to other medical or surgical therapies. With the huge development of LTx over the last 15 yrs, the disparity between the number of potential recipients and the number of donor organs available has become a major constraint, with many patients dying on the waiting lists. Therefore, it is of primary importance to control and optimise the use of this limited organ resource by weighting the risks and benefits of transplantation in individual patients, and to identify those patients who have a better chance of having a favourable outcome with transplantation.This article discusses the selection process of potential candidates and the currently accepted absolute and relative contraindications, and proposes general and disease-specific recommendations for optimising the timing of referral. Early referral for consideration of lung transplantation is highly desirable as it enhances the patient's chance of surviving to transplant and allows the transplant team to actively manage identified comorbidities during the waiting period.