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Immunosuppression for lung transplantation

Ng, CY and Madsen, JC and Rosengard, BR and Allan, JS (2009) Immunosuppression for lung transplantation. In: UNSPECIFIED UNSPECIFIED, 1627 - 1641. ISBN UNSPECIFIED

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Abstract

As a result of advances in surgical techniques, immunosuppressive therapy, and postoperative management, lung transplantation has become an established therapeutic option for individuals with a variety of end-stage lung diseases. The current 1-year actuarial survival rate following lung transplantation is approaching 80%. However, the 5-year actuarial survival rate has remained virtually unchanged at approximately 50% over the last 15 years due to the processes of acute and chronic lung allograft rejection (1). Clinicians still rely on a vast array of immunosuppressive agents to suppress the process of graft rejection, but find themselves limited by an inescapable therapeutic paradox. Insufficient immunosuppression results in graft loss due to rejection, while excess immunosuppression results in increased morbidity and mortality from opportunistic infections and malignancies. Indeed, graft rejection, infection, and malignancy are the three principal causes of mortality for the lung transplant recipient. One should also keep in mind that graft loss in a lung transplant recipient is usually a fatal event, since there is no practical means of long-term mechanical support, and since the prospects of re-transplantation are low, given the shortage of acceptable donor grafts. This chapter reviews the current state of immunosuppressive therapy for lung transplantation and suggests alternative paradigms for the management of future lung transplant recipients.


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Details

Item Type: Book Section
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Ng, CY
Madsen, JC
Rosengard, BR
Allan, JS
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 2009
Date Type: Publication
Journal or Publication Title: Frontiers in Bioscience
Volume: 14
Number: 5
Page Range: 1627 - 1641
DOI or Unique Handle: 10.2741/3330
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 2768-6701
Article Type: Review
Other ID: uls-drl:, Starzl CV No. 790
Date Deposited: 08 Apr 2010 17:13
Last Modified: 09 Nov 2021 11:55
URI: http://d-scholarship.pitt.edu/id/eprint/4176

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