Bridging to Lung Transplant: What Method and for Whom?

Abstract

Worldwide experience and expertise in lung transplant are increasing. For patients with end-stage respiratory disease this therapy greatly improves symptoms, eliminates the need for home oxygen therapy, and restores overall capacity. A major obstacle to increasing its availability as a treatment option is the limited number of donor organs. Patients who develop severe and progressive respiratory failure and are believed to be candidates for this treatment may be eligible for urgent lung transplantation. While waiting for donor organs to become available, methods to support respiratory function are essential to facilitate survival to transplant. Use of extracorporeal support to maintain gas exchange was first described two decades ago and has since developed substantially. We review current techniques available for bridging patients to lung transplant, and the indications and procedures for such support. Recent and historical clinical experience in this field is also discussed. © 2013 Springer Science+Business Media New York.