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Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible

Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to t...

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Autores principales: Balestro, Elisabetta, Cocconcelli, Elisabetta, Tinè, Mariaenrica, Biondini, Davide, Faccioli, Eleonora, Saetta, Marina, Rea, Federico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843894/
https://www.ncbi.nlm.nih.gov/pubmed/31635104
http://dx.doi.org/10.3390/medicina55100702
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author Balestro, Elisabetta
Cocconcelli, Elisabetta
Tinè, Mariaenrica
Biondini, Davide
Faccioli, Eleonora
Saetta, Marina
Rea, Federico
author_facet Balestro, Elisabetta
Cocconcelli, Elisabetta
Tinè, Mariaenrica
Biondini, Davide
Faccioli, Eleonora
Saetta, Marina
Rea, Federico
author_sort Balestro, Elisabetta
collection PubMed
description Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to those with IPF and were published before the widespread use of antifibrotic therapy. In this review, we discussed difficulties in decision-making when dealing with patients with IPF due to the wide variability in clinical course and life expectancy, as well as the acute deterioration associated with exacerbations. Indeed, the ideal timing for referral and listing for lung transplant remains challenging, and the acute deterioration might be influenced after transplant outcomes. Of note, patients with IPF are frequently affected by multimorbidity, thus a screening program for occurring conditions, such as coronary artery disease and pulmonary hypertension, before lung transplant listing is crucial to candidate selection, risk stratification, and optimal outcomes. Among several comorbidities, it is of extreme importance to highlight that the prevalence of lung cancer is increased amongst patients affected by IPF; therefore, candidates’ surveillance is critical to avoid organ allocation to unsuitable patients. For all these reasons, early referral and close longitudinal follow-up for potential lung transplant candidates are widely encouraged.
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spelling pubmed-68438942019-11-25 Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible Balestro, Elisabetta Cocconcelli, Elisabetta Tinè, Mariaenrica Biondini, Davide Faccioli, Eleonora Saetta, Marina Rea, Federico Medicina (Kaunas) Review Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to those with IPF and were published before the widespread use of antifibrotic therapy. In this review, we discussed difficulties in decision-making when dealing with patients with IPF due to the wide variability in clinical course and life expectancy, as well as the acute deterioration associated with exacerbations. Indeed, the ideal timing for referral and listing for lung transplant remains challenging, and the acute deterioration might be influenced after transplant outcomes. Of note, patients with IPF are frequently affected by multimorbidity, thus a screening program for occurring conditions, such as coronary artery disease and pulmonary hypertension, before lung transplant listing is crucial to candidate selection, risk stratification, and optimal outcomes. Among several comorbidities, it is of extreme importance to highlight that the prevalence of lung cancer is increased amongst patients affected by IPF; therefore, candidates’ surveillance is critical to avoid organ allocation to unsuitable patients. For all these reasons, early referral and close longitudinal follow-up for potential lung transplant candidates are widely encouraged. MDPI 2019-10-19 /pmc/articles/PMC6843894/ /pubmed/31635104 http://dx.doi.org/10.3390/medicina55100702 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Balestro, Elisabetta
Cocconcelli, Elisabetta
Tinè, Mariaenrica
Biondini, Davide
Faccioli, Eleonora
Saetta, Marina
Rea, Federico
Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible
title Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible
title_full Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible
title_fullStr Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible
title_full_unstemmed Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible
title_short Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible
title_sort idiopathic pulmonary fibrosis and lung transplantation: when it is feasible
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843894/
https://www.ncbi.nlm.nih.gov/pubmed/31635104
http://dx.doi.org/10.3390/medicina55100702
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