AUTHOR=Palleschi Alessandro , Mattioni Giovanni , LoMauro Antonella , Privitera Emilia , Musso Valeria , Morlacchi Letizia , Vergari Maurizio , Velardo Daniele , Grasselli Giacomo 

TITLE=Diaphragm and Lung Transplantation

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12897

DOI=10.3389/ti.2024.12897

ISSN=1432-2277

ABSTRACT=The diaphragm is the key respiratory muscle, and its function and morphology may undergo changes throughout the lung transplantation process. Before transplantation, several factors such as the underlying respiratory disease, the comorbidities, and the chronic treatments of the patients may impact on the diaphragm. At the time of lung transplantation, the surgical procedure itself can also significantly transform the diaphragm. Conversely, the diaphragm can influence various steps of lung transplantation, from the graft-recipient volume adaptation to the long-term posttransplantation respiratory function. Currently, there are no standardized criteria for defining and managing diaphragmatic function abnormalities in the setting of lung transplantation. In this review we summarize evidence concerning the identification of diaphragmatic dysfunction in lung transplantation patients, we explore which factors may influence the diaphragm before and after lung transplantation, how the function and the morphology of the diaphragm evolve across the entire lung transplantation process and what may signify the presence of a diaphragmatic dysfunction in this setting. In addition, we provide an overview of current and potential future treatments.