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Chapter 76 - Lung transplantation

from Section 18 - Cardiothoracic Surgery

Published online by Cambridge University Press:  05 September 2013

Michael F. Lubin
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Neil H. Winawer
Affiliation:
Emory University, Atlanta
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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 Patient
A Textbook of Perioperative Medicine
, pp. 591 - 593
Publisher: Cambridge University Press
Print publication year: 2013

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References

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Stewart, S, Fishbein, MC, Snell, GI et al. Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection. J Heart Lung Transpl 2007; 26: 1229–42.CrossRefGoogle Scholar

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