The donor lung: conservation of a precious resource

摘要: Lung transplantation became a reality in 1963 when Dr James Hardy performed the first successful single lung transplant1 patient with chronic pulmonary disease and bronchogenic carcinoma. His survived 18 days, eventually succumbing to renal failure. opportunity for success was hampered by lack of adequate immunosuppressive agents, limited perioperative monitoring, support systems such as haemodialysis. Over next two decades numerous transplants were performed. Although all ended failures, valuable information experience accumulated areas immune system alteration, diagnosis treatment rejection, opportunistic infections.2 The role prophylactic antibiotic regimens better defined. Since mid 1980s many these issues have been resolved, centres currently perform progressively survival rates. availability cyclosporin an agent allowed reduced doses corticosteroids be used has had dramatic impact on outcome transplantation. latest report from United Network Organ Sharing (UNOS)3 USA recognises 95 registered heart-lung 91 As more technological expertise transplantation, this technology expands treat wider range diseases, there inevitable increase number patients listed and, consequently, significant prolongation waiting times. This is problem which now affecting countries active transplant programmes; paper problems are discussed relation data USA. Transplant physicians constantly analyse fluctuation Patients must “get in” UNOS list at time they significantly irreversibly impaired their disease, …