ATS Reading List

Lung Transplantation

Annual ISHLT Registry Report

Lund L, Edwards L, Dipchand A, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-third Adult Heart Transplantation Report—2016; Focus Theme: Primary Diagnostic Indications for Transplant. The Journal of Heart and Lung Transplantation. 2016; 35:1158-69.
PMID: 27772668

Recipient Selection

Weill D, Benden C, Corris PA, et al. A consensus document for the selection of lung transplant candidates: 2014- An update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2015;34:1-15. Provides disease-specific summaries of indications and contraindications for transplantation, as well as recommendations for timing of referral.
PMID: 25085497
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Donor Selection and Management

Snell GI, Paraskeva M, Westall GP. Donor selection and management. Semin Respir Crit Care Med. 2013; 34:361-70. Provides an update on the selection, assessment, and management of potential donor organs.
PMID: 23821510

Mascia L, Pasero D, Slutsky AS, et al. Effect of a lung protective strategy for organ donors on eligibility and availability of lungs for transplantation: a randomized controlled trial. JAMA 2010;304:2620-7. This multicenter RCT found that a lung protective strategy entailing lower tidal volumes (6 – 8 ml/kg./IBW), higher PEEP (8 – 10 cm H2O), apnea tests performed on CPAP, and suctioning through a closed circuit resulted in lungs being harvested from 54% of potential donor compared to 27% among the conventional group. Of note, the study was stopped prematurely after enrolling 118 patients due to lack of funding.
PMID: 21156950
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Cybel M, Yeung JC, Liu M, et al. Normothermic ex vivo lung perfusion in clinical lung transplantation. N Engl J Med 2011; 364:1431-40. This study has sparked interest in the use of EVLP to identify the subset of high-risk donor organs that are actually suitable for transplantation. The single-center study found 20 high-risk donor organs with stable function while receiving 4 hours of EVLP had similar incidence of primary graft dysfunction following subsequent transplantation compared to 116 recipients of normal-risk donor organs (15% EVLP vs 30% control, p 0.11).
PMID:21488765
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Rejection

Ahmad S, Shlobin OA, Nathan SD. Pulmonary complications of lung transplantation. Chest 2011;139:402-11. In addition to various forms of rejection, this review discusses infectious and airway complications.
PMID: 21285054

McNeil K, Glanville AR, Wahlers T, et al. Comparison of mycophenolate mofetil and azathioprine for prevention of bronchiolitis obliterans syndrome in de novo lung transplant recipients. Transplantation 2006; 81:998-1003. There is controversy over whether MMF provides superior protection against rejection compared to azathioprine. This open label multicenter RCT of 315 newly transplanted patients found no differences in the incidence of acute rejection, severity of BOS, time to acquisition of BOS, or survival after 3 years of follow-up. All patients also received cyclosporine and corticosteroids. These results may have been affected by the higher proportion of patients withdrawing from azathioprine therapy (59.6% vs. 46.5% in MMF group, p = .02).
PMID: 16612275

Gerhardt SG, McDyer JF, Girgis RE, et al. Maintenance azithromycin therapy for bronchiolitis obliterans syndrome: results of a pilot study. Am J Respir Crit Care Med 2003; 168:121-5. Interesting pilot found chronic macrolide therapy improved the FEV1 in 5 of 6 patients with bronchiolitis obliterans syndrome. Subsequently published case series of up to 20 patients also found benefit, but no recent controlled studies have been performed.
PMID: 12672648

**See also Harris et al under Immunocompromised Host and Arcasoy et al under Pulmonary Hypertension

Last Reviewed: June 2017