Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Mar;155(3):465-473.
doi: 10.1016/j.chest.2018.08.1036. Epub 2018 Aug 29.

The Future of Lung Transplantation

Katherine A Young  1 , Daniel F Dilling  2
Affiliations
Review

The Future of Lung Transplantation

Katherine A Young et al. Chest. 2019 Mar.

Abstract

The field of lung transplant has made significant advances over the last several decades. Despite these advances, morbidity and mortality remain high when compared with other solid organ transplants. As the field moves forward, the speed by which progress can be made will in part be determined by our ability to overcome several stumbling blocks, including donor shortage, proper selection of candidates, primary graft dysfunction, and chronic lung allograft dysfunction. The advances and developments surrounding these factors will have a significant impact on shaping the field within the coming years. In this review, we look at the current climate (ripe for expanding the donor pool), new technology (ex vivo lung perfusion and bioengineered lungs), cutting-edge innovation (novel biomarkers and new ways to treat infected donors), and evidence-based medicine to discuss current trends and predict future developments for what we hope is a bright future for the field of lung transplantation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Actuarial survival of DDCD donor lung transplant (LTX) recipients (P = .04) vs DDND LTx recipients vs ISHLT registry survival: 2006-2011. Four Australian LTx centers performed a combined 72 DDCD LTx and 503 DDND LTx between May 2006 and May 2011. For comparison, the registry survival of the ISHLT during the same period is also shown. DDCD = donation after determination of cardiac death; DDND = donation after determination of neurologic death; ISHLT = International Society for Heart and Lung Transplantation.
Figure 2
Figure 2
A, Kaplan-Meier curves depict the freedom from death or retransplantation of patients receiving EVLP-treated lungs compared with recipients of conventional donor lungs in the entire study cohort. The y axis depicts the proportion of patients free from death or retransplant, and the x axis shows days after transplant. The number of patients at risk is shown below the x axis at yearly time points. Log-rank analyses were used to determine statistical significance. B, Kaplan-Meier curves depict the freedom from CLAD in patients receiving effects of EVLP-treated lungs compared with recipients of conventional donor lungs in the entire study cohort. The y axis depicts the proportion of patients free from CLAD, and the x axis shows days after transplant. The number of patients at risk is shown below the x axis at yearly time points. CLAD = chronic lung allograft dysfunction; EVLP = ex vivo lung perfusion.
Figure 3
Figure 3
Schematic of the possible future roles of ex vivo lung perfusion technology.
See this image and copyright information in PMC

References

    1. Hardy J.D., Webb W.R., Dalton M.L., Walker G.R. Lung homotransplantation in man: report of the initial case. JAMA. 1963;186(12):1065–1074. - PubMed
    1. Hachem R.R. Advancing lung transplantation. Clin Transpl. 2015;31:239–247. - PubMed
    1. Nathan S.D. The future of lung transplantation. Chest. 2015;147(2):309–316. - PubMed
    1. Valapour M., Skeans M.A., Heubner B.M. OPTN/SRTR 2013 annual data report: lung. Am J Transplant. 2015;15(suppl 2):1–28. - PubMed
    1. Gottlieb J. Lung allocation. J Thorac Dis. 2017;9(8):2670–2674. - PMC - PubMed

MeSH terms