4.5 Review Book Chapter

Advances in Human Lung Transplantation

期刊

ANNUAL REVIEW OF MEDICINE, VOL 72, 2021
卷 72, 期 -, 页码 135-149

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ANNUAL REVIEWS
DOI: 10.1146/annurev-med-080119-103200

关键词

lung transplantation; bronchiolitis obliterans; graft rejection; primary graft dysfunction; organ preservation

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Lung transplantation has substantially increased in volume in recent decades, with advances being made in understanding and treating post-transplant complications like CLAD. Ongoing studies are exploring novel approaches to improve long-term outcomes for lung transplant recipients.
Lung transplantation improves survival and quality of life in patients with advanced pulmonary disease. Over the past several decades, the volume of lung transplants has grown substantially, with increasing transplantation of older and acutely ill individuals facilitated by improved utilization and preservation of available donor organs. Other advances include improvements in the diagnosis and mechanistic understanding of frequent posttransplant complications, such as primary graft dysfunction, acute rejection, and chronic lung allograft dysfunction (CLAD). CLAD occurs as a result of the host immune response to the allograft and is the principal factor limiting long-term survival after lung transplantation. Two distinct clinical phenotypes of CLAD have emerged, bronchiolitis obliterans syndrome and restrictive allograft syndrome, and this distinction has enabled further understanding of underlying immune mechanisms. Building on these advances, ongoing studies are exploring novel approaches to diagnose, prevent, and treat CLAD. Such studies are necessary to improve long-term outcomes for lung transplant recipients.

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