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Current Pulmonology Reports

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01-12-2018 | Lung Transplant (R Bag, Section Editor)

Lung Transplantation in Connective Tissue Disease-Associated Interstitial Lung Disease (CTD-ILD)

Authors: Dennis Lyu, Kevin M. Chan

Published in: Current Pulmonology Reports | Issue 4/2018

Abstract

Purpose of Review

Connective tissue disease-related interstitial lung disease (CTD-ILD) previously was a relative contraindication to lung transplantation primarily due to extra-pulmonary involvement of the disease. Recent published information focusing on the diagnosis and management of the extra-pulmonary complexities associated with CTD-ILD that challenge the success of lung transplantation indicate similar outcomes when compared to idiopathic causes of interstitial lung disease. Recent literature examining appropriate wait-listing criteria, disease management, and outcomes after lung transplantation are discussed.

Recent Findings

Esophageal dysmotility with or without gastroesophageal reflux disease (GERD) is the most common reason for denying lung transplant candidacy. Recent multiple single-center studies and registry data now show that carefully selected scleroderma and non-scleroderma connective tissue disease patients have acceptable outcomes when compared to matched interstitial lung disease recipients.

Summary

Connective tissue disease patients have extra-pulmonary manifestations that must be considered and properly managed in the setting of lung transplantation. With appropriate candidate selection and proper management, lung transplantation is an acceptable treatment option for these individuals and should not be immediately abandoned based on extra-pulmonary complexities.

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Title: Lung Transplantation in Connective Tissue Disease-Associated Interstitial Lung Disease (CTD-ILD)
Authors: Dennis Lyu
Kevin M. Chan
Publication date: 01-12-2018
Publisher: Springer US
Published in: Current Pulmonology Reports / Issue 4/2018
Electronic ISSN: 2199-2428
DOI: https://doi.org/10.1007/s13665-018-0207-2

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