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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2010 March;49(1):45-63
An update in lung transplantation
Moneghetti K. J., Westall G. P., Snell G. I.
Department of Allergy, Immunology, and Respiratory Medicine, Lung Transplant Service, Alfred Hospital and Monash University, Melbourne, Australia
This review intends to highlight recent advances in the literature regarding the care of patients awaiting or undergoing lung transplantation. Lung transplantation is an established treatment for the management of end stage pulmonary vascular disease. Previous 5-year survival of 50 percent continues to improve in most centers across the world. Selection criteria of both recipients and donors continue to evolve as greater evidence is gathered through worldwide registers. This has resulted in a larger number of organs available and hence transplants completed. Outcomes in specific recipient sub-groups are enhancing the way clinicians use the procedure of lung transplantation. New immunosuppressive agents are reducing the rates of rejection although it is not yet clear whether this translates to improved long term outcomes. The recent completion of a number of randomized control trials will influence future prescribing patterns of immunosuppressive agents. As survival improves there are new medical issues to address including managing co-morbidities as well as modifying the mechanisms of chronic allograft dysfunction.