L'applicazione clinica del trapianto di polmone

Successful lung transplantation has taken longer to develop than other organ transplants. Nevertheless, lung transplantation has now become a viable clinical option for the treatment of irreversibile end-stage respiratory failures. A brief history of lung transplantation is followed by a discussion of the current surgical indications for single and double lung transplants. The criteria for the evaluation and preoperative management of potential candidates are reported. The surgical techniques used for harvesting, preserving and transplanting one or both lungs are then described, including the latest procedure of sequential bilateral lung transplantation. Almost 300 patients have undergone single or double lung transplants all over the world with a survival rate of more than 60%, the earliest patients surviving for over six years. Lung function and exercise tolerance have satisfactorily improved. Despite a number of problems in airway anastomosis and in diagnosing and treating rejection still to be resolved, lung transplantation is rapidly gaining ground worldwide