Skill Checkup: A 63-Year-Old Man With Persistent Cough and New Shortness of Breath

Zab Mosenifar, MD


April 21, 2022

Early evaluation for lung transplantation should be considered in patients with advanced disease refractory to medical therapy.

It is unclear whether bilateral lung transplantation is superior to single lung transplantation in patients with underlying IPF. Several studies have described improved survival with double lung transplant compared with single lung transplant in pulmonary fibrosis. A recent study examining recipients concurrently listed for single lung transplant and double lung transplant found that overall survival was similar regardless of procedure, though this topic is a priority for future research.

Treatment guidelines for IPF advise against the use of N-acetylcysteine monotherapy; bosentan or macitentan, both dual-acting ER antagonists that target ER-A and ER-B; and sildenafil, a phosphodiesterase-5 inhibitor.

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