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A lung from a 16-year-old donor would first be offered to the person in the age group 12–17 with the highest lung allocation score and matching blood type in the vicinity of the transplant center. If there no suitable recipient in that age group, it would next be offered to the highest LAS-scoring candidate who is under 12 years of age.
Although controversial, the most recent data suggest that bilateral lung transplantation is superior to single lung transplantation in patients with IPF. [57] Five-year survival rates after lung transplantation in IPF are estimated at between 50 and 56%. [3] [58] [59]
A 2019 cohort study of nearly 10,000 lung transplant recipients in the US demonstrated significantly improved long-term survival using sirolimus + tacrolimus (median survival 8.9 years) instead of mycophenolate mofetil + tacrolimus (median survival 7.1 years) for immunosuppressive therapy starting at one year after transplant.
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The median survival in idiopathic pulmonary fibrosis is 3-3.5 years. In those who receive a lung transplant, the medial survival in idiopathic pulmonary fibrosis is 5.2 years, as compared to 6.7 years in those with other types of ILD. [8] ILD is associated with a 3-fold increased risk of lung cancer. [8]
Prior to operating on the recipient, the transplant surgeon inspects the donor lung(s) for signs of damage or disease. If the lung or lungs are approved, then the recipient is connected to an IV line and various monitoring equipment, including pulse oximetry. The patient will be given general anesthesia, and a machine will breathe for them. [1]
Lung transplantation may be an option in severe cases. [6] The frequency of occurrence is estimated at 1,000 new cases per year in the United States. [3] [1] Females are more often affected than males. [1] Onset is typically between 20 and 60 years of age. [3] Pulmonary hypertension was identified by Ernst von Romberg in 1891. [9] [4]
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