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ABSTRACT
The first lung transplantation was performed successfully in 1983 and has become a viable option for end-stage pulmonary disease. Advances in surgical techniques, the development of better immunosuppressive agents, and the standardization of care have improved patient survival and quality of life. This article includes statistics on men versus women diagnosed with Chronic Obstructive Pulmonary Disease. Included with this article is a case report of a 52-year-old white male who had undergone a bilateral lung transplant. The patient's medication protocol is discussed within this article, including the use of inhaled cyclosporine to treat acute cellular rejection, one of the major complications associated with lung transplantation. The formulation for the cyclosporine for aerosol that was prepared by a compounding pharmacist is included with this article.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Chronic Obstructive Pulmonary Disease (COPD), a slowly progressive disease of the respiratory system that is characterized by a gradual loss of'lung Function, is the fourth leading cause of death in the U.S.1 Sidebar 1 lists some information and statistics about COPD. ÇOPD is a general term used to describe several respiratory diseases:
* Chronic bronchitis
* Chronic obstructive bronchitis
* Emphysema
* Combinations of these conditions
The largest risk factor for developing COPD is cigarette smoking; although other types of tobacco smoking will increase the risk. Other documented causes of COPD include occupational exposure to dusts and chemicals. Currently there is no known cure for COPD, and the treatment is usually supportive to relieve symptoms and improve quality of life for the patient. The symptoms of COPD can become severe anà life threatening. In adults, COPD is the common reason attributed to lung transplantation.
The first lung transplantation was performed successfully in 1983 and has become a viable option for end-stage pulmonary disease. Sidebar 2 provides a list of common diseases that may require transplantation. Advances in surgical techniques, the development of better immunosuppressive agents, and the standardization of care have improved patient survival2 (see sidebar 3 for survival statistics) and quality of life. Lung transplantation involves removing a patient's diseased lung and replacing ir with a healthy lung from a deceased donor or bealrhv lobes from a couple ofliving donors. Of the possible transplantations (e.g., kidney, heart), lung transplantations are less common due...