Lungentransplantation bei Mukoviszidose – ein Positionspapier

Zusammenfassung

Die Lungentransplantation bei Mukoviszidose ist eine inzwischen etablierte Therapieoption, da die große Mehrzahl der Erwachsenen mit cystischer Fibrose eine respiratorische Insuffizienz entwickelt. Auch Jugendliche und Kinder können erfolgreich transplantiert werden. Allerdings hat die Lungentransplantation bei Mukoviszidose Besonderheiten bei der Kandidatenselektion, Operation und Nachsorge gegenüber anderen Grundkrankheiten. In Anbetracht des Organmangels und langen Wartezeiten in Deutschland sollen mögliche Kandidaten frühzeitig im Transplantationszentrum vorgestellt werden. Bei der Auswahl muss der voraussichtliche Transplantationserfolg gemessen an der Verbesserung der Lebensqualität und der Prognose berücksichtigt und Kontraindikationen beachtet werden. Die zentrumsbasierte Nachsorge nach Transplantation und die enge Kooperation mit heimatnahen Ärzten ist ein entscheidender Faktor für den Langzeiterfolg. Bei Problemen in der Nachsorge und bei Änderungen der Medikation ist eine umgehende Kontaktaufnahme mit dem Transplantationszentrum unabdingbar.

Abstract

Lung transplantation in cystic fibrosis is an established therapy. Due to the fact that vast majority of adult CF patients will develop respiratory failure. Even adolescents and children can be transplanted successfully today. Lung transplantation in cystic fibrosis requires special consideration concerning candidate selection, surgery and postoperative follow-up care. Due to a donor shortage and increasing waiting time, early referral to transplant centres of potential candidates is crucial. In the process of candidate selection, assumed improvements in quality of life and survival benefit should be weighed against contraindications. Centre-based follow-up and close cooperation with local physicians are key factors for success. During follow-up care, the transplantation team should be contacted immediately in the case of any problem or change in medication.

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