Lung transplantation: a 15-year single-center experience.

During the past decade, the outcome after lung transplantation has improved due to a substantial reduction in the immediate postoperative and perioperative mortality that resulted from better surgical techniques, anaesthetic and perioperative management and more intense antibiotic, antifungal and antiviral prophylaxis. However, according to the International Society for Heart and Lung transplantation (ISHLT) Registry, the long-term survival has not improved much in recent years and mortality is most often due to the development of chronic allograft dysfunction, infections, posttransplant lymphoproliferative disorders and other tumours. Although treatment options have improved for most of these issues, therapy for chronic allograft dysfunction has been very disappointing. Recent observations using azithromycin and antireflux surgery may shed more light on the pathophysiology and perhaps the outcome of this debilitating condition. We hope that better prevention and treatment of chronic allograft dysfunction will result in better long-term survival after lung transplantation.