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Lung transplantation 

Lung transplantation
Chapter:
Lung transplantation
Author(s):

Derek Rosen

, Marcelo Cypel

, and Peter D. Slinger

DOI:
10.1093/med/9780199651429.003.0032
Page of

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date: 21 August 2019

The number of lung transplantations performed each year continues to increase and the short- and long-term survivals for recipients continue to improve. As a corollary, more patients with significant comorbidities, such as cardiac and liver disease, are now accepted for lung transplantation and the complexity of their anaesthetic management continues to increase. Fundamental to managing these patients is an understanding of the different pathophysiologies and intraoperative complications which are specific to the various types of recipients: emphysema vs cystic fibrosis vs pulmonary fibrosis vs primary pulmonary hypertension, etc. Better donor-lung preservation techniques and conditioning strategies such as ex-vivo perfusion have decreased the incidence of early transplant-reperfusion injury during surgery. Current trends such as the increased use of intraoperative transoesophageal echocardiography and extracorporeal membrane oxygenation have helped in the management of intraoperative cardiac instability and severe gas exchange problems.

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