Lung Transplant

Airway: Access: Pain: Position: Time: Blood loss: Special:

Transplant of either one or both lungs for advanced non-malignant lung disease. Lung transplant can be performed:

Off-bypass
On VA ECMO
Off VA ECMO

Bilateral transplant makes up ~75% of all transplants.

Single lung transplant is not appropriate for suppurative lung disease but can be performed for:

COPD
Not α₁-antitrypsin related.
Pulmonary fibrosis

Surgical Stages

Historically performed as a single en-bloc transplant, but high incidence of tracheal anastomotic failure has led to development of the bilateral sequential single lung transplant technique, where each lung is transplanted in turn.

Preoperative

Assessment: Consultation: Optimisation: Premedication: Explain/Consent:

Intraoperative

Preparation: Induction: Maintenance: Echocardiography: Emergence:

Postoperative

Disposition: Referrals/Review: Analgesia: Fluids: Thromboprophylaxis: Specific:

References

Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.