In their recent open-access article for the Zentralblatt für Chirurgie, Drs.: Szofia Kovacs, Alberto Benazzo, and Peter Jaksch review the latest International Society for Lung and Heart Transplantion (ISHLT) guidelines on lung transplantation, highlighting a major shift toward personalized, inclusive care. Beyond the underlying lung disease, transplant decisions now consider age, frailty, comorbidities, and psychosocial context broadening access for many.
For patients with pulmonary arterial hypertension (PAH), bilateral lung transplantation remains the preferred treatment in advanced stages. Yet current allocation scores (LAS) often fail to reflect pulmonary arterial hypertension severity, leading to low priority on the waiting list. Many patients rely on exception requests, and new tools like the Composite Allocation Score and therapies such as sotatercept may offer hope for fairer access.
The review also expands on other key indications: Idiopathic Pulmonary Fibrosis (IPF), Chronic Obstructive Pulmonary Disease (COPD), Cystic Fibrosis (CF), post-COVID ARDS, and even patients with prior cancers, HIV, or multidrug-resistant infections groups that are now being reconsidered thanks to medical advances. Retransplantation, while more complex, also remains a viable option in select cases.
This article marks an important step in recognizing that early referral and nuanced evaluation can improve both survival and quality of life for transplant candidates including those living with pulmonary arterial hypertension.
Read more at this link on Research Gate
Available in English and German
Citation
Kovacs Z, Benazzo A, Jaksch P. Indikationsspektrum zur Lungentransplantation – Weiterentwicklungen seit den letzten ISHLT-Empfehlungen. Zentralbl Chir. 2025;150:68–72. DOI: 10.1055/a-2563-3691 Open Access under CC BY 4.0