Lung transplantation: Procedure and postoperative management
- Marcelo Cypel, MD, MSc
Marcelo Cypel, MD, MSc
- Assistant Professor, Division of Thoracic Surgery
- University of Toronto
- Tom Waddell, MD, MSc, PhD, FRCS, FACS
Tom Waddell, MD, MSc, PhD, FRCS, FACS
- Professor, Division of Thoracic Surgery
- University of Toronto
- Shaf Keshavjee, MD, MSc, FRCSC, FACS
Shaf Keshavjee, MD, MSc, FRCSC, FACS
- Professor, Division of Thoracic Surgery
- University of Toronto
Lung transplantation has become an increasingly important mode of therapy for patients with a variety of end-stage lung diseases [1,2]. Five types of transplant procedures are generally available:
●Single lung transplantation (SLT)
●Bilateral lung transplantation (BLT)
●Cadaveric lobar transplants (CLT)
●Transplantation of lobes from living related donors
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- OVERVIEW OF THE PROCEDURE
- Single lung transplantation
- Bilateral lung transplantation
- Living donor lobar transplantation
- Cadaveric lobar transplants
- Heart-lung transplantation
- TECHNICAL CONSIDERATIONS
- Bronchial anastomosis
- Extracorporeal cardiorespiratory support
- - Indications
- - Choice of modality
- POSTOPERATIVE MANAGEMENT
- Ventilatory support and weaning
- Fluid management
- Management of primary graft dysfunction
- Chest tube management
- Initiation of immunosuppression
- Infection prophylaxis
- Prevention of venous thromboembolism
- Nutritional support and stress ulcer prophylaxis
- MONITORING AND FOLLOW-UP AFTER DISCHARGE
- Lung function
- Flexible bronchoscopy
- Maintenance immunosuppression
- Choice of procedure
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS