Lung transplantation has been developed over the last fifteen years as a therapeutic option for different forms of advanced-stage
lung disease.
Idiopathic pulmonary fibrosis is a good indication. For these patients, single
lung transplantation is usually preferred, bilateral
lung transplantation to a lesser extent. Survival is similar for these two types of
transplantation. The post-
transplantation survival in patients with
pulmonary fibrosis is about 65-70% at one year and 40% at five years. This rate is lower than observed for
COPD or
cystic fibrosis. If there are no complications, the patient can recover nearly normal lifestyle. Among the different complications,
reimplantation edema,
infection, rejection, and bronchial complications predominate. Chronic rejection, also called obliterative
bronchiolitis syndrome, is a later complication which can be observed in about half of the patients. Improvement in graft survival depends greatly in improvement in prevention and management of complications. Despite such complications, graft survival in
fibrosis patients is greater than spontaneous survival on the waiting list; idiopathic
fibrosis is associated with the highest mortality on the waiting list. Patients should be referred early for the pre-
transplantation work-up because individual prognosis is very difficult to predict.