Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible
Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/55/10/702 |
| _version_ | 1797728626340265984 |
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| author | Elisabetta Balestro Elisabetta Cocconcelli Mariaenrica Tinè Davide Biondini Eleonora Faccioli Marina Saetta Federico Rea |
| author_facet | Elisabetta Balestro Elisabetta Cocconcelli Mariaenrica Tinè Davide Biondini Eleonora Faccioli Marina Saetta Federico Rea |
| author_sort | Elisabetta Balestro |
| collection | DOAJ |
| description | Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to those with IPF and were published before the widespread use of antifibrotic therapy. In this review, we discussed difficulties in decision-making when dealing with patients with IPF due to the wide variability in clinical course and life expectancy, as well as the acute deterioration associated with exacerbations. Indeed, the ideal timing for referral and listing for lung transplant remains challenging, and the acute deterioration might be influenced after transplant outcomes. Of note, patients with IPF are frequently affected by multimorbidity, thus a screening program for occurring conditions, such as coronary artery disease and pulmonary hypertension, before lung transplant listing is crucial to candidate selection, risk stratification, and optimal outcomes. Among several comorbidities, it is of extreme importance to highlight that the prevalence of lung cancer is increased amongst patients affected by IPF; therefore, candidates’ surveillance is critical to avoid organ allocation to unsuitable patients. For all these reasons, early referral and close longitudinal follow-up for potential lung transplant candidates are widely encouraged. |
| first_indexed | 2024-03-12T11:17:44Z |
| format | Article |
| id | doaj.art-7ca43aeb63934a1a90538776331ca488 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T11:17:44Z |
| publishDate | 2019-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-7ca43aeb63934a1a90538776331ca4882023-09-02T01:49:09ZengMDPI AGMedicina1010-660X2019-10-01551070210.3390/medicina55100702medicina55100702Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is FeasibleElisabetta Balestro0Elisabetta Cocconcelli1Mariaenrica Tinè2Davide Biondini3Eleonora Faccioli4Marina Saetta5Federico Rea6Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35128 Padova, ItalyDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35128 Padova, ItalyDespite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to those with IPF and were published before the widespread use of antifibrotic therapy. In this review, we discussed difficulties in decision-making when dealing with patients with IPF due to the wide variability in clinical course and life expectancy, as well as the acute deterioration associated with exacerbations. Indeed, the ideal timing for referral and listing for lung transplant remains challenging, and the acute deterioration might be influenced after transplant outcomes. Of note, patients with IPF are frequently affected by multimorbidity, thus a screening program for occurring conditions, such as coronary artery disease and pulmonary hypertension, before lung transplant listing is crucial to candidate selection, risk stratification, and optimal outcomes. Among several comorbidities, it is of extreme importance to highlight that the prevalence of lung cancer is increased amongst patients affected by IPF; therefore, candidates’ surveillance is critical to avoid organ allocation to unsuitable patients. For all these reasons, early referral and close longitudinal follow-up for potential lung transplant candidates are widely encouraged.https://www.mdpi.com/1010-660X/55/10/702idiopathic pulmonary fibrosislung transplantationacute exacerbationcomorbidities |
| spellingShingle | Elisabetta Balestro Elisabetta Cocconcelli Mariaenrica Tinè Davide Biondini Eleonora Faccioli Marina Saetta Federico Rea Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible Medicina idiopathic pulmonary fibrosis lung transplantation acute exacerbation comorbidities |
| title | Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible |
| title_full | Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible |
| title_fullStr | Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible |
| title_full_unstemmed | Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible |
| title_short | Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible |
| title_sort | idiopathic pulmonary fibrosis and lung transplantation when it is feasible |
| topic | idiopathic pulmonary fibrosis lung transplantation acute exacerbation comorbidities |
| url | https://www.mdpi.com/1010-660X/55/10/702 |
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