Lung transplantation: Procedure and postoperative management

INTRODUCTION

Over the past decade, lung transplantation has become an increasingly important mode of therapy for patients with a variety of end-stage lung diseases [1]. Four types of transplant procedures are generally available [2]:

  • Single lung transplantation (SLT)
  • Bilateral lung transplantation (BLT)
  • Transplantation of lobes from living related donors
  • Heart-lung transplantation (HLT)

The procedures of single, bilateral, and living donor lobar lung transplantation and issues related to the early postoperative management will be reviewed here. The indications for each type of transplant, technique of heart-lung transplantation, donor lung preparation, and immunosuppression are discussed separately [1]. (See "Lung transplantation: General guidelines for recipient selection" and "Lung transplantation: Deceased donor evaluation and management" and "Lung transplantation: Donor lung preservation" and "Heart-lung transplantation" and "Induction immunosuppression following lung transplantation".)

PREPARATION

The recipient is prepared for surgery once a donor lung has been identified, but induction of anesthesia is postponed until the donor lung has been inspected and approved by the retrieval team. If the donor lung is satisfactory, the recipient operation begins while the donor lung is in transit. (See "Lung transplantation: Donor lung preservation".)

SINGLE LUNG TRANSPLANTATION

Single lung transplantation extends the limited supply of donor organs to more patients, but it provides less lung function as a buffer for late complications. The indications for single versus bilateral transplantation are discussed separately. (See "Lung transplantation: Disease-based choice of procedure".)

                   

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Literature review current through: Apr 2013. | This topic last updated: Sep 11, 2012.
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