Indications and results of lung transplantation for idiopathic pulmonary fibrosis

Lung transplantation is an established therapy-option for patients with various end stages of pulmonary diseases and presently the worldwide frequency is about 3,500 procedures per year. Unfortunately, the shortage of donor organs leads to approximately every sixth patient in western countries dying before a donor organ is available. The most frequent underlying clinical indications are emphysema, pulmonary fibrosis and cystic fibrosis. In a recent analysis 23 % of all recipients worldwide had a diagnosis of idiopathic-pul-monary fibrosis. In experienced centers, candidates for transplantation are chosen according to disease- specific factors under prognostic aspects after excluding contra- indications. However, there are several challenges for lung transplantation. The number of lung transplantations performed is limited by the supply of donor organs and the longterm survival rates are still inferior compared to other forms of solid organ transplantation. Nevertheless, lung transplantation offers a survival benefit in carefully selected patients with interstitial lung diseases, especially with idiopathic pulmonary fibrosis.