Lung transplantation. General aspects and problems during systemic diseases

End stage respiratory diseases are the best indications to lung transplantation (heart-lung, single and double lung), on the other hand systemic diseases are usually contraindication to transplant. The improvement in surgical technique, in immunosuppressive regimens and in dealing with infectious complications have contributed to the improvement of survival statistic. Nevertheless, the shortage of organ donors and many clinical problems before and after lung transplantation suggest to have clear guidelines on main topics. In particular, among patients with rheumatic diseases, we should consider 2 kinds of problems: the indication to the lung transplantation, and the bone and muscle diseases interesting most patients with chronic respiratory failure. In this paper a survey is made of the state of art on disease indications and contraindications, patients selection, preoperative evaluation, awaiting list inclusion, treatment procedure choice and timing, and rehabilitation before and after lung transplantation.