Lung Transplantation: A Final Option for End-Stage Interstitial Lung Diseases

Lung transplantation (LTx) is an established, well-recognized medical intervention for treating patients with an end-stage irreversible pulmonary disease. Such diseases include interstitial lung disease (ILD), where other standard medical options often have been proven as insufficient. Post-operative survival after LTx depends on various factors such as the general and organ-specific recipient status in addition to donor organ condition and operative technique. The prolonged survival rates obtained during the 1980s and 1990s have established LTx in the medical field. Reflecting the improvements made in the field of organ preservation, operative technique, immunosuppressants, recipient and donor organ selection and prophylactic as well as direct treatment in the wide spectrum of possible infections in the recipient. Despite LTx being the golden standard for treating end-stage irreversible ILD, with idiopathic pulmonary fibrosis (IPF) as the most common cause, postoperative outcome is greatly hampered compared to the outcome of other patient categories within LTx. This chapter will provide insight in the outcome of ILD and subsequently IFP after LTx.