Lung Transplantation in COPD

Abstract

Chronic obstructive pulmonary disease (COPD) remains one of the leading causes of morbidity and mortality both in the United States and worldwide. Despite advances in medical treatment including smoking cessation, bronchodilator therapy, oxygen administration, and pulmonary rehabilitation, patients with advanced COPD still suffer significant debility. For select patients with severe COPD, there are additional surgical options including lung volume reduction surgery and ultimately lung transplantation. This article discusses the history, clinical indications, selection of candidates, choice of procedure, and outcomes of lung transplantation in patients with advanced COPD. In addition, certain aspects of potential short- and long-term complications of transplantation will also be discussed.

Sarcoidosis lung transplantation waitlist mortality, a national registry database study

“…1 The implementation of the LAS system in May 2005 immediately shortened the time to transplantation and decreased waitlist mortality for the most commonly transplanted lung diseases: idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF). 2,3 Patients with IPF benefited most from the LAS. 4 It is less clear how the LAS affected lung transplantation waitlist outcomes in patients with less commonly transplanted lung diseases such as advanced pulmonary sarcoidosis (APS).…”

“…Introduced in May 2005 in the United States, the Lung Allocation Score (LAS) system uses diagnosis, functional status, exercise capacity, lung function, haemodynamic data and supplemental oxygen needs to prioritise patients with the highest urgency of lung transplantation while considering the chances of survival post-transplant [ 1 ]. The implementation of the LAS system in May 2005 immediately shortened the time to transplantation and decreased waitlist mortality for the most commonly transplanted lung diseases: idiopathic pulmonary fibrosis (IPF), COPD and cystic fibrosis [ 2 , 3 ]. Patients with IPF benefited most from the LAS [ 4 ].…”

Development and validation of a nomogram model to predict primary graft dysfunction in patients after lung transplantation based on the clinical factors

“…Lung transplantation (LTx) is an effective treatment modality for the end‐stage lung diseases 1 . The primary graft dysfunction (PGD) that lung transplant patients experience following surgery is the main complication that develops within 72 h of surgery and results in perioperative death in patients, according to information from the International Society for Heart and Lung Transplantation (ISHLT) 2–4 . PGD is defined as lung injury occurring within 72 h after lung implantation, 5 as evidenced by an PaO 2 /FiO 2 ratio below 300 and diffuse allograft edema and infiltration on chest radiographs 6,7 .…”