Leading experts will debate the positives and negatives of several key issues this week at the 2010 ATS International Conference, starting with Tuesday’s “C83: Hot Topics in Lung Transplantation: Pro-Con Debates” session.

There are many issues in the field that require an in-depth debate to reach consensus and provide optimal care for lung transplant recipients, said session co-chair Keith C. Meyer, M.D.

“Lung transplantation is a very complex undertaking, and care of the lung transplant recipient may vary considerably among transplant programs and across continents,” he said. “The goal of the symposium is to discuss issues in lung transplantation for which approaches taken by different centers or individuals may vary or for which consensus does not exist.'”

Dr. Meyer, who is professor of medicine at the University of Wisconsin, Madison, said the first debate, “Bronchiolitis Obliterans Syndrome (BOS) is Still the Best Term for Delayed-Onset Chronic Lung Allograft Dysfunction Following Lung Transplantation,” focuses on terminology that is used for patients with declining lung function in the subacute to chronic phase of transplantation after the lung has stabilized—and the patient has recovered from the surgery and successfully made it through the post-transplant period, when allograft function stabilizes and reaches optimal function.

“When patients appear to develop BOS, other potential causes of lung function decline should be considered before concluding that patients have BOS/chronic rejection,” he said.

The second debate, “The U.S. LAS (lung allocation score) System is the Best Way to Allocate Organs to Patients with Advanced Lung Disease,” will cover a system adopted by the United States in 2005 for prioritizing patients in need of lung transplants.

“Lung allocation systems should be constantly re-evaluated and refined to optimize post-transplant outcomes and use of a scarce resource as a treatment for progressive advanced lung disease that is unresponsive to non-surgical therapeutic interventions,” Dr. Meyer said.

The third debate, “Gastric Fundoplication Should be Performed as a Prophylactic Measure to Prevent Reflux and BOS in Lung Transplant Recipients,” will cover an attempt to reach an agreement on how to approach and manage gastroesophageal reflux (GER) in lung transplant recipients.

“GER is a major risk for loss of allograft function in the post-transplant setting, and a standardized approach to its detection and treatment is needed,” Dr. Meyers said.