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Gaps and Future Directions in Lung Transplantation

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Lung Transplantation

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Abstract

Lung transplantation (LTX) may be the only intervention that can improve quality of life for individuals with advanced lung disease and can prolong survival in advanced lung diseases such as idiopathic pulmonary fibrosis or cystic fibrosis that progress despite non-transplant therapies. However, some patients considered for lung transplantation are extremely ill and require ventilator and/or circulatory support as a bridge to transplant. Indeed, many early complications can threaten lung allograft viability, and delayed onset of decline in function due to chronic lung allograft dysfunction (CLAD) or other posttransplant complications such as opportunistic infection significantly impact recipient survival and long-term outcomes. Many advances in pre- and posttransplant management have led to improved outcomes over the past decade. These include the creation of sound guidelines for candidate selection, improved surgical techniques, improved methods for donor lung preservation, advances in the suppression and treatment of allograft rejection, the development of prophylaxis protocols to decrease the risk of opportunistic infection, more effective therapies for treating infectious complications, and the development of a clinical practice guideline to treat and manage CLAD. Nonetheless, many gaps in knowledge concerning the optimization of the initial transplant procedure, perioperative management, and the prevention of subacute and chronic allograft dysfunction persist. This chapter discusses evolving advances in the field of lung transplantation, identifies persistent gaps in knowledge, and discusses what the future may hold for lung transplantation as a more attractive and viable option for patients confronted with premature death due to end-stage lung disease.

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Authors and Affiliations

  1. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Keith C. Meyer

  2. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine University of Washington, Seattle, WA, USA

    Ganesh Raghu

  3. Center for Interstitial Lung Disease, ILD, Sarcoid and Pulmonary Fibrosis Program, University of Washington Medicine, Seattle, WA, USA

    Ganesh Raghu

  4. Scleroderma Clinic, University of Washington Medicine, Seattle, WA, USA

    Ganesh Raghu

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  1. Keith C. Meyer
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  2. Ganesh Raghu
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Correspondence to Keith C. Meyer .

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Editors and Affiliations

  1. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine University of Washington, Seattle, Washington, USA

    Ganesh Raghu

  2. Department of Internal Medicine, University of Genoa, Genoa, Italy

    Roberto G. Carbone

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Meyer, K.C., Raghu, G. (2018). Gaps and Future Directions in Lung Transplantation. In: Raghu, G., Carbone, R. (eds) Lung Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-91184-7_21

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  • DOI: https://doi.org/10.1007/978-3-319-91184-7_21

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