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- W4322734840 abstract "La transplantation pulmonaire (TP) conduit à une situation volontiers polypathologique, dont le suivi est centré sur 3 axes : 1/le maintien de la fonction respiratoire ; 2/la gestion des comorbidités ; 3/la médecine préventive. On compte en France environ 3000 porteurs d’un greffon (cardio)pulmonaire pour 11 centres de TP. L’augmentation de la cohorte des transplantés suggère la possibilité d’un partage du suivi avec des centres de proximité. Cet article présente les propositions d’un groupe de travail de la SPLF sur les modalités de ce suivi partagé (SP). Le centre de TP coordonne l’ensemble du suivi et particulièrement la gestion de l’immunosuppression. Certains centres de proximité identifiés peuvent participer alternativement au suivi de routine et/ou à la gestion de certaines comorbidités et complications aiguës. La communication entre les 2 centres doit être fluide. Le SP pourrait notamment être proposé aux patients stables, consentants à partir de la 3e année postopératoire. A contrario, les patients inobservants ou instables sont de moins bons candidats au SP. Les éléments présentés sont un référentiel possible pour aider tout pneumologue volontaire à maintenir, en sécurité, le suivi d’un patient même après la transplantation. Lung transplantation (LT) requires sustained care for a frequently polypathological condition. Follow-up is focused on three main issues: 1/stability of respiratory function; 2/comorbidity management; 3/preventive medicine. About 3000 LT patients in France are treated in 11 LT centers. Given the increased size of the LT recipient cohort, follow-up might be partially shared with peripheral centers. This paper presents the suggestions of a working group of the SPLF (French-speaking respiratory medicine society) on possible modalities of shared follow-up. While the main LT center is tasked with centralizing follow-up, particularly the choice of optimal immunosuppression, an identified peripheral center (PC) may serve as an alternative to deal with acute events, comorbidities and routine assessment. Communication between the different centers should be free-flowing. Shared follow-up may be offered from the 3rd postoperative year to stable and consenting patients, whereas unstable and non-observant patients are poor candidates. These guidelines may serve as a reference for any pneumologist wishing to effectively contribute to follow-up, even and especially subsequent to lung transplant." @default.
- W4322734840 created "2023-03-03" @default.
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- W4322734840 date "2023-04-01" @default.
- W4322734840 modified "2023-09-30" @default.
- W4322734840 title "Suivi partagé des patients transplantés pulmonaires" @default.
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- W4322734840 doi "https://doi.org/10.1016/j.rmr.2023.01.024" @default.
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