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Anaesthesia for lung transplantation 

Anaesthesia for lung transplantation
Chapter:
Anaesthesia for lung transplantation
Author(s):

Nandor Marczin

, Lakshminarasimhan Kuppurao

, I. Gavin Wright

, and Andre R. Simon

DOI:
10.1093/med/9780199653478.003.0035
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date: 14 October 2019

The chapter provides an overview on the issues related to lung transplantation. It defines overall anaesthetic goals to minimize determinants of perioperative risks. Recipient and donor related risk factors are discussed with focus on modifiable conditions. Manifest or subclinical donor lung injury is explored and difficulties related to brain death or non-heart beating donations are highlighted. State of the art novel efforts to maximize donation and improve quality of allografts are described, including various forms of ex vivo lung perfusion. Preoperative evaluation and preparation of the recipient is discussed. Special emphasis is paid to dynamic hyperinflation and pulmonary hypertension, two conditions frequently encountered during induction. One section examines anaesthetic management and the surgical process using bilateral sequential lung transplantation as the principal example. The phenomenon of primary graft dysfunction is treated extensively, as the most severe form of lung injury. The principal concepts of postoperative intensive care of lung transplant recipients are also illuminated.

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