Interstitial lung diseases(ILD)encompass a diverse group of over 200 chronic pulmonary disorders characterized by varying degrees of inflammation and fibrosis,which can lead to severe respiratory impairment.Lung trans...Interstitial lung diseases(ILD)encompass a diverse group of over 200 chronic pulmonary disorders characterized by varying degrees of inflammation and fibrosis,which can lead to severe respiratory impairment.Lung transplantation offers a crucial therapeutic option for patients with advanced ILD,extending survival and improving quality of life.This review explores optimal management strategies in both the pre-and post-transplant phases to enhance patient outcomes.Comprehensive pre-transplant evaluation,including pulmonary function testing,imaging,and comorbidity assessment,is critical for determining transplant eligibility and timing.Post-transplant care must focus on preventing complications such as primary graft dysfunction and chronic lung allograft dysfunction,managed through tailored immunosuppression and proactive monitoring.Recent advancements in diagnostic techniques and therapeutic approaches,including emerging technologies like ex vivo lung perfusion and precision medicine,promise to further improve outcomes.The ultimate goal is to establish an evidencebased,multidisciplinary framework for optimizing ILD management and lung transplantation.展开更多
Lung transplantation(LT)is currently a surgical therapy option for end-stage lung disease.Venous thromboembolism(VTE),which can occur after LT,is associated with significant morbidity and mortality.Because of improved...Lung transplantation(LT)is currently a surgical therapy option for end-stage lung disease.Venous thromboembolism(VTE),which can occur after LT,is associated with significant morbidity and mortality.Because of improved out-comes,increasing numbers of patients are receiving LT as treatment.Patients on the waitlist for LT tend to be older with weakness and frailty in addition to pulmonary symptoms.These factors contribute to a heightened risk of post-operative VTE.Furthermore,patients who clinically deteriorate while on the waitlist may require extra corporeal membrane oxygenation as a bridge to LT.Bleeding and thromboembolism are common in these patients.Pulmonary embolism(PE)in a freshly transplanted lung can have significant effects leading to morbidity and mortality.PE typically leads to impairment of gas exchange and right ventricular strain.In LT,PE can affect healing of bronchial anastomosis and may even contribute to the development of chronic allograft lung dysfunction.This article discussed the incidence,clinical features and diagnosis of VTE after LT.Furthermore,the treatment modalities,complications,and outcomes of VTE were reviewed.展开更多
Chronic lung allograft dysfunction(CLAD)following lung transplantation limits long-term survival considerably.The main reason for this is a lack of knowledge regarding the pathological condition and the establishment ...Chronic lung allograft dysfunction(CLAD)following lung transplantation limits long-term survival considerably.The main reason for this is a lack of knowledge regarding the pathological condition and the establishment of treatment.The consensus statement from the International Society for Heart and Lung Transplantation on CLAD in 2019 classified CLAD into two main phenotypes:Bronchiolitis obliterans syndrome and restrictive allograft syndrome.Along with this clear classification,further exploration of the mechanisms and the development of appropriate prevention and treatment strategies for each phenotype are desired.In this review,we summarize the new definition of CLAD and update and summarize the existing knowledge on the underlying mechanisms of bronchiolitis obliterans syndrome and restrictive allograft syndrome,which have been elucidated from clinicopathological observations and animal experiments worldwide.展开更多
文摘Interstitial lung diseases(ILD)encompass a diverse group of over 200 chronic pulmonary disorders characterized by varying degrees of inflammation and fibrosis,which can lead to severe respiratory impairment.Lung transplantation offers a crucial therapeutic option for patients with advanced ILD,extending survival and improving quality of life.This review explores optimal management strategies in both the pre-and post-transplant phases to enhance patient outcomes.Comprehensive pre-transplant evaluation,including pulmonary function testing,imaging,and comorbidity assessment,is critical for determining transplant eligibility and timing.Post-transplant care must focus on preventing complications such as primary graft dysfunction and chronic lung allograft dysfunction,managed through tailored immunosuppression and proactive monitoring.Recent advancements in diagnostic techniques and therapeutic approaches,including emerging technologies like ex vivo lung perfusion and precision medicine,promise to further improve outcomes.The ultimate goal is to establish an evidencebased,multidisciplinary framework for optimizing ILD management and lung transplantation.
文摘Lung transplantation(LT)is currently a surgical therapy option for end-stage lung disease.Venous thromboembolism(VTE),which can occur after LT,is associated with significant morbidity and mortality.Because of improved out-comes,increasing numbers of patients are receiving LT as treatment.Patients on the waitlist for LT tend to be older with weakness and frailty in addition to pulmonary symptoms.These factors contribute to a heightened risk of post-operative VTE.Furthermore,patients who clinically deteriorate while on the waitlist may require extra corporeal membrane oxygenation as a bridge to LT.Bleeding and thromboembolism are common in these patients.Pulmonary embolism(PE)in a freshly transplanted lung can have significant effects leading to morbidity and mortality.PE typically leads to impairment of gas exchange and right ventricular strain.In LT,PE can affect healing of bronchial anastomosis and may even contribute to the development of chronic allograft lung dysfunction.This article discussed the incidence,clinical features and diagnosis of VTE after LT.Furthermore,the treatment modalities,complications,and outcomes of VTE were reviewed.
文摘Chronic lung allograft dysfunction(CLAD)following lung transplantation limits long-term survival considerably.The main reason for this is a lack of knowledge regarding the pathological condition and the establishment of treatment.The consensus statement from the International Society for Heart and Lung Transplantation on CLAD in 2019 classified CLAD into two main phenotypes:Bronchiolitis obliterans syndrome and restrictive allograft syndrome.Along with this clear classification,further exploration of the mechanisms and the development of appropriate prevention and treatment strategies for each phenotype are desired.In this review,we summarize the new definition of CLAD and update and summarize the existing knowledge on the underlying mechanisms of bronchiolitis obliterans syndrome and restrictive allograft syndrome,which have been elucidated from clinicopathological observations and animal experiments worldwide.
