Pneumologie 2011; 65(7): 419-427
DOI: 10.1055/s-0030-1255938
Serie: Lungentransplantation

© Georg Thieme Verlag KG Stuttgart · New York

Pneumologische Rehabilitation vor und nach Lungentransplantation

Pulmonary Rehabilitation Before and After Lung TransplantationK.  Kenn1 , B.  Sczepanski1
  • 1Schön Klinik Berchtesgadener Land, Schönau a. Königssee
Further Information

Publication History

eingereicht 13. 9. 2010

akzeptiert nach Revision 15. 10. 2010

Publication Date:
22 February 2011 (online)

Zusammenfassung

Die pneumologische Rehabilitation von Patienten mit fortgeschrittenen Lungenerkrankungen, vor allem bei COPD-Patienten, hat in den letzten Jahren an Bedeutung gewonnen. Für die Indikation Lungentransplantation (LTx) fehlen größere Studien sowohl im Hinblick auf die prä- wie auf die postoperative Rehabilitation. Dennoch finden sich zunehmend Hinweise, dass die präoperative Stabilisierung und Vorbereitung ebenso wie eine gezielte postoperative Trainingstherapie unverzichtbar zum gesamten LTx-Therapiekonzept dazugehören sollten, da der Transplantationserfolg hierdurch verbessert werden kann. Die präoperative Phase kann durch Verbesserung von Kraft, Ausdauer und Alltagsmobilität zur Überbrückung der Wartezeit genutzt werden. Zusätzlich sind intensive Motivation und Wissensvermittlung möglich, um die Patienten auf die Transplantation vorzubereiten. Ziel der postoperativen Rehabilitation ist es, mit Hilfe einer verbesserten Atemleistung die körperliche Leistungsfähigkeit und die Lebensqualität zu steigern. Dieser Beitrag stellt den Stellenwert, die Zielsetzung und die Besonderheiten einer Rehabilitation vor und nach einer Lungentransplantation dar. Abschließend wird die Bedeutung dieses perioperativen Konzepts für ein ressourcenlimitiertes und sehr kostenintensives Therapieverfahren diskutiert.

Abstract

Pulmonary rehabilitation of patients with advanced lung diseases especially with COPD patients has become more important over past years. For patients in which lung transplantation is indicated major studies concerning pre- and postoperative rehabilitation are still missing. Nevertheless, growing evidence suggests that training therapy and other components of comprehensive rehabilitation should be an essential part of the whole concept in order to augment the therapeutic success of LTx. The time prior to LTx may be used as „bridging to transplant” by improving strength, endurance and mobility. Intensive motivation and knowledge transfer can prepare patients as good candidates. The rehabilitation after LTx aims at regaining physical abilities and health related quality of life using the increased breathing capacities. The manuscript presents the importance, aims and specific features of rehabilitation prior to and following LTx. Finally the therapeutic concept will be discussed with regard to the economic burden and the limited resources in lung transplantation.

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Bisher erschienene Beiträge dieser Serie

Dr. Klaus Kenn

Schön Klinik Berchtesgadener Land

Malterhöh 1
83471 Schönau a. Königssee

Email: KKenn@schoen-kliniken.de

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