天美传媒

Lung transplantation; Transplantation; Pulmonary disease; Idiopathic pulmonary fibrosis

Introduction

Indications for Lung Transplantation

The most common indications for lung transplantation include chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), cystic fibrosis (CF), and pulmonary hypertension (PH). These conditions lead to irreversible lung damage and failure, resulting in severe respiratory symptoms and impaired quality of life [1]. Patients who are unresponsive to conventional therapies, such as medication and oxygen therapy, may be candidates for lung transplantation.

Evaluation of Lung Transplant Candidates

Lung transplantation is a complex procedure that requires careful evaluation of potential candidates. The evaluation process involves a thorough medical history, physical examination, pulmonary function tests, imaging studies, and laboratory tests (Kaminski, 2018). Candidates are assigned a lung allocation score (LAS), which is based on the severity of their respiratory disease and other medical factors. Patients with higher LAS scores are given priority for lung transplantation [2].

Selection of Donor Lungs

The availability of suitable donor lungs is a major limiting factor in lung transplantation. Donor lungs must match the blood type and size of the recipient and be free from infection, cancer, and other diseases (Mulligan et al., 2018). The use of extended criteria donors, such as older donors and those with a history of smoking or previous lung disease has expanded the donor pool but also increases the risk of complications following transplantation [3].

Surgical Techniques

Lung transplantation is typically performed through a median sternotomy or a bilateral thoracotomy approaches (Baxter et al., 2018). The damaged or diseased lungs are removed, and the donor lung is implanted. The bronchus, pulmonary artery, and pulmonary vein are reconnected to the corresponding structures of the recipient’s chest. The procedure may also involve the transplantation of other organs, such as the heart, liver, or kidneys [4].

Immunosuppression

Immunosuppression is necessary after lung transplantation to prevent rejection of the donor lung. A combination of medications, such as corticosteroids, calcineurin inhibitors, and antimetabolites, is used to suppress the immune system and reduce the risk of rejection. However, these medications also increase the risk of infection and other complications, and they require careful monitoring and adjustment [5].

Complications

Lung transplantation is associated with significant morbidity and mortality. The most common complications include infection, rejection, and graft dysfunction. Infection can occur due to the immunosuppressive medications used after transplantation [6]. Rejection occurs when the recipient’s immune system recognizes the donor lung as foreign and attacks it. Graft dysfunction can occur due to various factors, including ischemia-reperfusion injury, infection, and rejection.

Outcomes

Despite the risks and complications associated with lung transplantation, the procedure can significantly improve the quality of life and survival of patients with end-stage pulmonary disease. The survival rates after lung transplantation vary depending on the underlying disease, age, and other medical factors [7]. The overall survival rate at 1 year is approximately 80%, and the median survival time is 5-7 years. The results of heart and lung transplantation rely upon a wide scope of elements. The recipient’s survival and the function of the graft are significantly compromised by post-transplant complications. Long-term survival of recipients while maintaining their high quality of life was made possible by carefully selected and controlled immunosuppression, regular monitoring, and timely complications diagnosis [8].

Discussion

The results of heart and lung transplantation rely upon a wide scope of elements. The recipient’s survival and the function of the graft are significantly compromised by post-transplant complications. Long-term survival of recipients while maintaining their high quality of life was made possible by carefully selected and controlled immunosuppression, regular monitoring, and timely complications diagnosis. People in good health. The earlier findings that potential heart and lung recipients upregulated miR-424 are supported by this study [9]. In patients before and after HTx and LTx, there was no correlation between miR-424 expression levels and age or gender. There was no connection between’s the degree of coursing miR-424 and the most broad research facility and biochemical blood boundaries of heart and lung relocate beneficiaries, which might demonstrate the freedom and generally high particularity of this miR-424. In addition, our hypothesis that miR-424 is involved in the progression of hypoxia, vascular remodeling, and neoangiogenesis is supported by the correlation between miR-424 levels in red blood cells and hemoglobin in patients with chronic heart failure. It is likely that as the number of people who have received lung transplants grows, it will be possible to observe any correlation between miR-424 levels and standard blood parameters [10].

Conclusion

Lung transplantation is a life-saving treatment option for patients with end-stage pulmonary disease. Advances in surgical techniques, immunosuppression, and organ preservation have improved outcomes for patients undergoing transplantation. However, the availability of suitable donor lungs remains a limiting factor. Lung transplantation is associated with significant morbidity and mortality, and careful selection of candidates and monitoring of complications are crucial for success. Despite these challenges, lung transplantation can significantly improve the quality of life and survival of patients with end-stage pulmonary disease.

1. Reppel L, Schiavi J, Charif N, Leger L, Yu H, et al. (2015) Chondrogenic induction of mesenchymal stromal/stem cells from Wharton's jelly embedded in alginate hydrogel and without added growth factor: an alternative stem cell source for cartilage tissue engineering. Stem Cell Res Ther 6:260.

, ,

2. Anzalone R, Lo Iacono M, Corrao S, Magno F, Loria T, et al. (2010) New emerging potentials for human Wharton's jelly mesenchymal stem cells: immunological features and hepatocyte-like differentiative capacity. Stem Cells Dev 19:423-38.

, ,

3. Russo E, Caprnda M, Kruzliak P, Conaldi PG, Borlongan CV, et al. (2022) . Stem Cells Int 245:41-68.

, , Crossref

4. Serrenho I, Rosado M, Dinis A, M Cardoso C, Graos M, et al. (2021)  . Int J Mol Sci. 22:3142.

, ,

5. Liu Y, Fang J, Zhang Q, Zhang X, Cao Y, et al. (2020). J Orthop Translat 23:29-37.

, ,

6. Arrigoni C, Arrigo D, Rossella V, Candrian C, Albertini V, et al. (2020) Cells 9(6):13-43.

, ,

7. Kohler H, Pashov AD, Kieber-Emmons T (2019) Commentary: Immunology's Coming of Age. Front Immunol 10:21-75.

, ,

8. Leone P, Solimando AG, Malerba E, Fasano R, Buonavoglia A, et al. (2020) . Front Oncol 10:597-598.

, ,

9. Kageyama T, Yoshimura C, Myasnikova D, Kataoka K, Nittami T, et al. (2018) . Biomaterials 154:291-300.

, ,

10. Kageyama T, Chun YS, Fukuda J (2021) . Sci Rep 11:6-24.

, ,