TY - JOUR
T1 - Selecting lung transplant candidates
T2 - Where do current guidelines fall short?
AU - Hook, Jaime L.
AU - Lederer, David J.
N1 - Funding Information:
DJ Lederer is a steering committee member for the ASCEND trial of pirfenidone for idiopathic pulmonary fibrosis sponsored by Intermune, is coinvestigator in clinical trials for idiopathic pulmonary fibrosis sponsored by Gilead and Boehringer-Ingelheim and has served on advisory boards for Gilead in 2010 and 2011. DJ Lederer was supported by NIH grant numbers K23 HL086714 and R01 HL103676. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
PY - 2012/2
Y1 - 2012/2
N2 - In 2010, 1770 lung transplant procedures were performed in the USA, yet 2469 new candidates were added to the waiting list the same year. The shortage of suitable donor lungs requires that transplant professionals select patients for lung transplantation only if they are likely to sustain a survival benefit from the procedure. However, 20% of lung transplant recipients die within the first year of transplantation, suggesting that we are failing to identify those at high risk for severe early complications. In this perspective, we review the current guidelines for the selection of lung transplant candidates, which are based largely on expert opinion and small case series. We also propose the study of new extrapulmonary factors, such as frailty and sarcopenia, that might help improve the prediction of complications and early death after lung transplantation, leading to an improved candidate selection process.
AB - In 2010, 1770 lung transplant procedures were performed in the USA, yet 2469 new candidates were added to the waiting list the same year. The shortage of suitable donor lungs requires that transplant professionals select patients for lung transplantation only if they are likely to sustain a survival benefit from the procedure. However, 20% of lung transplant recipients die within the first year of transplantation, suggesting that we are failing to identify those at high risk for severe early complications. In this perspective, we review the current guidelines for the selection of lung transplant candidates, which are based largely on expert opinion and small case series. We also propose the study of new extrapulmonary factors, such as frailty and sarcopenia, that might help improve the prediction of complications and early death after lung transplantation, leading to an improved candidate selection process.
KW - Chronic obstructive pulmonary disease
KW - Frailty
KW - Interstitial lung disease
KW - Lung transplantation
KW - Obesity
KW - Pulmonary arterial hypertension
KW - Sarcopenia
UR - http://www.scopus.com/inward/record.url?scp=84856410788&partnerID=8YFLogxK
U2 - 10.1586/ers.11.83
DO - 10.1586/ers.11.83
M3 - Review article
C2 - 22283579
AN - SCOPUS:84856410788
SN - 1747-6348
VL - 6
SP - 51
EP - 61
JO - Expert Review of Respiratory Medicine
JF - Expert Review of Respiratory Medicine
IS - 1
ER -