{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:00:23Z","timestamp":1790082023657,"version":"4.0.1"},"reference-count":85,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Lungentransplantation hat sich seit den 1980er-Jahren durch Fortschritte in chirurgischen Techniken und der Einf\u00fchrung von Immunsuppressiva wie Ciclosporin zu einem etablierten Therapieverfahren entwickelt. Trotz verbesserter kurzzeitiger Ergebnisse bleibt die Langzeitprognose, insbesondere durch immunologische Komplikationen, eingeschr\u00e4nkt. Mit einer medianen \u00dcberlebenszeit von etwa 6 Jahren ist die Lunge aufgrund ihrer Exposition gegen\u00fcber Umweltantigenen und einer gro\u00dfen vaskul\u00e4ren Endothelfl\u00e4che das solide Organ mit der gr\u00f6\u00dften Immunogenit\u00e4t. Nach einer Lungentransplantation spielen verschiedene Formen der Alloreaktivit\u00e4t, einschl. der T-Zell-vermittelten akuten und chronischen Absto\u00dfungen eine zentrale Rolle. Erg\u00e4nzend tragen humorale Immunantworten durch die Bildung donorspezifischer und Non-HLA-Antik\u00f6rper zur Transplantatsch\u00e4digung bei. Wiederkehrende Gewebesch\u00e4den, etwa durch Isch\u00e4mie-Reperfusions-Sch\u00e4den, f\u00fchren zur Freilegung kryptischer Antigene, f\u00f6rdern\n      autoreaktive Prozesse und beg\u00fcnstigen die Bildung terti\u00e4rer lymphatischer Organe. Diese Prozesse unterhalten eine anhaltende Entz\u00fcndungsreaktion, die zur chronischen Transplantatdysfunktion f\u00fchren kann. Absto\u00dfungsreaktionen bleiben eine gro\u00dfe Herausforderung. Akute Formen, wie zellul\u00e4re und humorale Absto\u00dfungen, erfordern schnelle, gezielte Therapien, um irreversible Sch\u00e4den zu verhindern. Chronische Absto\u00dfungen, insbesondere die chronische Lungenallograft-Dysfunktion (CLAD) verschlechtern die Lungenfunktion langfristig. Die Unterscheidung der Hauptph\u00e4notypen der CLAD, dem Bronchiolitis-obliterans-Syndrom und dem restriktiven Allograft-Syndrom, ist entscheidend f\u00fcr Prognose und Therapie. Dennoch sind die Behandlungsm\u00f6glichkeiten limitiert, sodass eine Retransplantation oft die letzte Option darstellt. Die immunsuppressive Therapie bildet die Grundlage zur Pr\u00e4vention von Absto\u00dfungen. Sie umfasst meist eine Dreifachkombination aus Calcineurininhibitoren, antiproliferativen\n      Substanzen und Kortikosteroiden. F\u00fcr die Induktionstherapie kommen monoklonale oder polyklonale Antik\u00f6rper zum Einsatz. Moderne Strategien zielen darauf ab, Immunantworten effektiv zu unterdr\u00fccken und gleichzeitig schwerwiegende Nebenwirkungen wie Infektionen, Malignome und Nephrotoxizit\u00e4t zu minimieren. Zuk\u00fcnftige Forschungsans\u00e4tze fokussieren sich auf personalisierte Immunsuppressionsstrategien, optimierte Diagnostik und innovative Therapieans\u00e4tze, um die Langzeitprognose von Lungentransplantierten zu verbessern.<\/jats:p>","DOI":"10.1055\/a-2590-9933","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T23:08:52Z","timestamp":1747177732000},"page":"295-305","source":"Crossref","is-referenced-by-count":2,"title":["Immunologische Aspekte nach der Lungentransplantation"],"prefix":"10.1055","volume":"150","author":[{"given":"Caroline","family":"Hillebrand","sequence":"additional","affiliation":[{"name":"Thoraxchirurgie, Medizinische Universit\u00e4t Wien, Wien, \u00d6sterreich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Benazzo","sequence":"additional","affiliation":[{"name":"Thoraxchirurgie, Medizinische Universit\u00e4t Wien, Wien, \u00d6sterreich"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1001\/jama.1963.63710120001010","article-title":"Lung Homotransplantation in Man","volume":"186","author":"JD Hardy","year":"1963","journal-title":"JAMA"},{"key":"ref2","first-page":"244","article-title":"Preliminary experience with cyclosporin A in human renal allografts","volume":"12","author":"ON Fernando","year":"1980","journal-title":"Transplant Proc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1016\/j.healun.2019.08.001","article-title":"The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult lung and heart\u2013lung transplantation Report\u20142019; Focus theme: Donor and recipient size match","volume":"38","author":"DC Chambers","year":"2019","journal-title":"J Heart Lung Transplant"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.3109\/08830185.2014.913442","article-title":"Transplant immunology","volume":"38","author":"MM Aw","year":"2003","journal-title":"J Pediatr Surg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"352","DOI":"10.4049\/jimmunol.162.1.352","article-title":"Contributions of direct and indirect T cell alloreactivity during allograft rejection in mice","volume":"162","author":"G Benichou","year":"1999","journal-title":"J Immunol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1835","DOI":"10.1084\/jem.156.6.1835","article-title":"Immunogenicity of retransplanted rat kidney allografts. 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