Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Chapter 68 Coronary artery bypass procedures
- Chapter 69 Cardiac rhythm management
- Chapter 70 Aortic valve surgery
- Chapter 71 Mitral valve surgery
- Chapter 72 Ventricular assist devices and cardiac transplantation
- Chapter 73 Thoracic aortic disease
- Chapter 74 Pulmonary lobectomy
- Chapter 75 Pneumonectomy
- Chapter 76 Lung transplantation
- Chapter 77 Hiatal hernia repair
- Chapter 78 Esophagomyotomy
- Chapter 79 Esophagogastrectomy
- Chapter 80 Colon interposition for esophageal bypass
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Chapter 76 - Lung transplantation
from Section 18 - Cardiothoracic Surgery
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Chapter 68 Coronary artery bypass procedures
- Chapter 69 Cardiac rhythm management
- Chapter 70 Aortic valve surgery
- Chapter 71 Mitral valve surgery
- Chapter 72 Ventricular assist devices and cardiac transplantation
- Chapter 73 Thoracic aortic disease
- Chapter 74 Pulmonary lobectomy
- Chapter 75 Pneumonectomy
- Chapter 76 Lung transplantation
- Chapter 77 Hiatal hernia repair
- Chapter 78 Esophagomyotomy
- Chapter 79 Esophagogastrectomy
- Chapter 80 Colon interposition for esophageal bypass
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Summary
Over the course of almost 50 years, lung transplantation has evolved from an experimental project to a significant means to prolong life and its quality in carefully selected patients with end-stage lung diseases. The introduction of cyclosporine as an immunosuppressive agent in the 1980s allowed for sufficient graft survival to make clinical lung transplantation a reality. Since then, more than 32,000 lung transplants have been performed.
Usual postoperative course
Expected postoperative hospital stay
Lung transplantation is a very complex surgical procedure. Usually the hospital stay is lengthy, close to 2 weeks if no complications occur. There is also an association between more severe disease, as determined by high lung allocation scores, and longer durations of hospital stay, averaging 5–6 weeks.
Operative mortality
Advances in surgical technique have lowered the rate of surgical complications and overall mortality. However, the rate of medical complications (usually a consequence of immunosuppression needed to ensure the survivability of the graft) still remains high. The inescapable constant exposure of the lungs to the environment also contributes to the significantly decreased survival rates of lung transplant recipients when compared with other solid organ recipients. Hence, in spite of relatively good 30-day and 1-year survival, the 5-year survival post lung transplant remains at 50%.
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 591 - 593Publisher: Cambridge University PressPrint publication year: 2013