Lung transplantation: An integrative review on survival, indications and outcomes in patients

• DOI: https://doi.org/10.22533/at.ed.15951025110251

• Palavras-chave: Lung Transplant, Review, Thoracic Surgery

• Keywords: Lung Transplant, Review, Thoracic Surgery

• Abstract:

  Lung transplantation is an advanced treatment for terminal lung diseases, offering improved survival and quality of life. However, challenges such as organ shortages and surgical risks remain. This integrative review analyzed 21 studies published in the last five years to understand the advances made in this period in relation to survival, indications and clinical outcomes of lung transplantation.
  Advances in surgical techniques and perioperative management have improved survival rates. Ex vivo lung perfusion (EVLP) has shown survival rates of 100% at 30 days, while extracorporeal membrane oxygenation (ECMO) has shown potential for stabilizing patients before transplantation. Physical rehabilitation showed benefits, with an 18% increase in functional capacity in adults and a 22% improvement in lung function in children.
  The main indications include idiopathic pulmonary fibrosis, cystic fibrosis and pulmonary sequelae of COVID-19. Antifibrotic therapies help with transplant eligibility by reducing disease progression. Patients in specialized centers have shown better prognoses, while geographical barriers negatively affect survival.
  Complications such as diaphragmatic paralysis (10% of cases) and atrial arrhythmias (4.1% per year) impact outcomes. Technologies such as Pocket PATH help with treatment adherence, improving long-term results.
  Thus, this review highlights important findings for improvements in organ allocation, post-operative management and equitable access to transplantation. Future research could optimize selection criteria and clinical protocols, contributing to better outcomes and greater accessibility to the procedure.