Lung transplantation

Abstract

Lung transplantation is a globally accepted treatment for some advanced lung diseases, giving the recipients longer survival and better quality of life. Since the first transplant successfully performed in 1983, more than 40 thousand transplants have been performed worldwide. Of these, about seven hundred were in Brazil. However, survival of the transplant is less than desired, with a high mortality rate related to primary graft dysfunction, infection, and chronic graft dysfunction, particularly in the form of bronchiolitis obliterans syndrome. New technologies have been developed to improve the various stages of lung transplant. To increase the supply of lungs, ex vivo lung reconditioning has been used in some countries, including Brazil. For advanced life support in the perioperative period, extracorporeal membrane oxygenation and hemodynamic support equipment have been used as a bridge to transplant in critically ill patients on the waiting list, and to keep patients alive until resolution of the primary dysfunction after graft transplant. There are patients requiring lung transplant in Brazil who do not even come to the point of being referred to a transplant center because there are only seven such centers active in the country. It is urgent to create new centers capable of performing lung transplantation to provide patients with some advanced forms of lung disease a chance to live longer and with better quality of life.

Thoracic surgery in Brazil: an overview

“…Distinct from North America and some countries in Europe, Brazil’s lung allocation system respects the chronological listing time, not specific prognostic scores such as Organ Procurement Transplantation Network (OPTM) Lung Allocation Score ( 20 ). On the other hand, similarly to the worldwide tendencies, Brazilian programs are performing progressively more bilateral transplants with increasing use of ECMO technology, with comparable survival results to those reported in the international literature ( 21 ).…”

miR-141 exacerbates lung ischemia-reperfusion injury by targeting EGFR/β-catenin axis-mediated autophagy

“…However, reperfusion itself can also trigger a series of complex events, which is the so-called ischemia-reperfusion injury (IRI). Take lung transplantation as an example, in the process of lung transplantation, although complete and long-term hypoxia lasts for only several hours, it causes unimaginable but unavoidable consequences [ 1 ]. Severe IRI leads to primary graft dysfunction (PGD), which accounts for the main cause of high short-term and long-term morbidity and mortality rates after lung transplantation [ 17 ].…”

“…Lung transplantation has become the only effective treatment for end-stage benign lung diseases induced by various causes [ 1 ]. However, compared with other organ transplantation (such as heart transplantation, kidney transplantation, and liver transplantation), the 5-year survival rate after lung transplantation is reported to be about 60%, and about 24% of patients die while waiting for donor lungs [ 2 ].…”

PLK1 Inhibition alleviates transplant-associated obliterative bronchiolitis by suppressing myofibroblast differentiation

“…Lung transplantation improves the quality of life of terminal lung disease patients [1]. In spite of advances to prevent acute transplant rejection, chronic allograft dysfunction (CAD) is still a major barrier for long-term survival of patients with transplanted organs [2].…”