The evolution of lung transplantation for cystic fibrosis: A 2017 update.
Identifieur interne : 000213 ( Main/Exploration ); précédent : 000212; suivant : 000214The evolution of lung transplantation for cystic fibrosis: A 2017 update.
Auteurs : Gregory Snell [Australie] ; Anna Reed [Royaume-Uni] ; Marc Stern [France] ; Denis Hadjiliadis [États-Unis]Source :
- Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [ 1873-5010 ] ; 2017.
Abstract
Lung transplantation (LTx) is an established therapy for patients with end-stage cystic fibrosis (CF). Indeed, CF is the commonest indication for those aged<50years of age needing LTx. CF LTx is associated with a 45% 10year survival - according to the world's largest registry. It is important all otherwise suitable CF patients with severe lung disease have a timely referral for discussion and consideration of the possibility of LTx. LTx discussions must carefully consider colonisation or infection with Burkholderia cenocepacia, Mycobacterium abscessus and Scediosporium - as good LTx outcomes cannot be guaranteed. A bridge to LTx with extra-corporeal lung support is a realistic option, but remains a relative contraindication to LTx. Improvements in LTx matching technology and post-operative management are steadily improving overall long-term outcomes, although chronic allograft rejection remains problematic. Expert multidisciplinary life-long post-LTx care remains the key to success.
DOI: 10.1016/j.jcf.2017.06.008
PubMed: 28711221
Affiliations:
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CF LTx is associated with a 45% 10year survival - according to the world's largest registry. It is important all otherwise suitable CF patients with severe lung disease have a timely referral for discussion and consideration of the possibility of LTx. LTx discussions must carefully consider colonisation or infection with Burkholderia cenocepacia, Mycobacterium abscessus and Scediosporium - as good LTx outcomes cannot be guaranteed. A bridge to LTx with extra-corporeal lung support is a realistic option, but remains a relative contraindication to LTx. Improvements in LTx matching technology and post-operative management are steadily improving overall long-term outcomes, although chronic allograft rejection remains problematic. 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