PREFERRED PRACTICE PATTERN
A 16-year-old female is referred to a local outpatient physical therapy clinic 4 months after receiving a double-lung transplant due to cystic fibrosis (CF). She was receiving physical therapy three times a week at the hospital where she received the transplant. Her goal is to progress to swimming as her primary aerobic workout but has been working to progress her exercise tolerance and endurance using a treadmill and stationary bike. She also wants to increase her overall strength.
Diseased or defective lung (single-lung transplant) or lungs (double-lung transplant) or a portion thereof is removed
Healthy partial lung from a living donor or complete donor lung(s) from a deceased person is implanted
Most common causes in children under 1 year of age are congenital heart disease (CHD), peripheral vascular disease (PVD), and CF
Lung transplant considered when patient death is imminent within 1 to 2 years and all other medical options have been exhausted and/or are ineffective1
Timing of transplant for over 12 years of age depends on their lung allocation score (LAS)
Long-term outcomes are limited
Contraindications to lung transplant
Forty-four lung transplants in 2011
Males more common than females
0.02% pediatric lung transplants (<18 years old)
Double-lung transplants 5 to 6 times more common than single-lung transplants
Number of patients awaiting lung transplants and number of lung transplants performed each year. Data derived from Scientific Registry of Transplant Recipients, 2002 (http://www.ustransplant.org).
Different types of tissue transplants (grafts). (From Chandrasoma P, Taylor CR. Concise Pathology 3rd ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
Possible Contributing Causes
Idiopathic pulmonary fibrosis (IPF)
Bronchiolitis obliterans (BO)
Pulmonary vascular disorder
Chronic lung disease of infancy
Pulmonary fibrosis/Idiopathic pulmonary fibrosis (IPF)
Pulmonary vein anomalies
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