Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1783468323495739392 |
---|---|
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. |
format | Online Article Text |
id | pubmed-6843894 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT balestroelisabetta idiopathicpulmonaryfibrosisandlungtransplantationwhenitisfeasible AT cocconcellielisabetta idiopathicpulmonaryfibrosisandlungtransplantationwhenitisfeasible AT tinemariaenrica idiopathicpulmonaryfibrosisandlungtransplantationwhenitisfeasible AT biondinidavide idiopathicpulmonaryfibrosisandlungtransplantationwhenitisfeasible AT facciolieleonora idiopathicpulmonaryfibrosisandlungtransplantationwhenitisfeasible AT saettamarina idiopathicpulmonaryfibrosisandlungtransplantationwhenitisfeasible AT reafederico idiopathicpulmonaryfibrosisandlungtransplantationwhenitisfeasible |