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Lungentransplantation

Möglichkeiten und Grenzen

Lung transplantation: potentials and limitations

  • Schwerpunkt: Transplantationsmedizin
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Die Lungentransplantation ist ein Therapieverfahren für Patienten in Endstadien von Lungenerkrankungen mit begrenzter Prognose, bei denen keine Kontraindikationen vorliegen. Für Krankheitsbilder wie die zystische Fibrose, die Lungenfibrose, z. T. auch das Lungenemphysem deutet sich durch die Lungentransplantation ein Überlebensvorteil für die Betroffenen an. Die Weiterentwicklung und gezielte Auswahl der chirurgischen Verfahren haben die Frühsterblichkeit deutlich reduziert. Die Langzeitergebnisse konnten in den letzten Jahren verbessert werden, bleiben aber noch hinter denen anderer Organübertragungen zurück. Die Lebensqualität nimmt in der Regel deutlich zu, die Leistungsfähigkeit bleibt aber hinter der Altersnorm zurück. Transplantationsspezifische Probleme sind häufigere akute und chronische Abstoßungen, Infektionen, Atemwegskomplikationen und maligne Tumoren. Nach 5 Jahren können inzwischen Überlebensraten von ca. 60% erreicht werden.

Abstract

Lung transplantation is an option for patients with endstage pulmonary diseases without contraindications. Recent European studies showed a survival benefit for patients with cystic fibrosis, fibrosis and emphysema after lung transplantation. Early mortality has been reduced recently by surgical improvements. Life expectancy after lung transplantation has improved in recent years but is still lower than in patients with other solid organ transplantations. Quality of life is consistently improved but exercise tolerance keeps reduced in comparison to the normal population. Specific problems described in detail are frequent organ rejections and infections, airway problems and a high incidence of malignant diseases. 5-year survival after lung transplantation is in average 60%.

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Authors and Affiliations

  1. Abteilung Pneumologie, Medizinische Hochschule Hannover

    J. Gottlieb, T. Welte & M. M. Höper

  2. Abteilung Herz-, Thorax- und Gefäßchirurgie, Medizinische Hochschule Hannover

    M. Strüber

  3. Medizinische Klinik I, Krankenhaus Bad Oeynhausen

    J. Niedermeyer

  4. Abteilung Pneumologie, Medizinische Hochschule, Carl-Neuberg-Straße 1, 30625, Hannover

    J. Gottlieb

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  1. J. Gottlieb
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  2. T. Welte
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  3. M. M. Höper
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  4. M. Strüber
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  5. J. Niedermeyer
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Correspondence to J. Gottlieb.

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Gottlieb, J., Welte, T., Höper, M.M. et al. Lungentransplantation. Internist 45, 1246–1260 (2004). https://doi.org/10.1007/s00108-004-1292-6

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  • DOI: https://doi.org/10.1007/s00108-004-1292-6

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