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Anesthesia in Lung Transplantation

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Thoracic Surgery

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Abstract

Lung transplantation is one of the most challenging procedures and requires a specialized cardiothoracic anesthesiologist. Adequate preoperative assessment is necessary to objectify underlying diseases and the impact of pulmonary diseases on hemodynamics. High vigilance and skills in managing acute hemodynamic and ventilation changes are essential. The anesthesiologist must be knowledgeable in single lung ventilation, extracorporeal circulation devices and echocardiography examination. This chapter provides guidance on how to take care of patients undergoing such a procedure.

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References

  1. Levy B, Fritz C, Tahon E, Jacquot A, Auchet T, Kimmoun A. Vasoplegia treatments: the past, the present, and the future. Crit Care. 2018;22:52.

    Article  Google Scholar 

  2. Sarkar J, Golden PJ, Kajura LN, Murata LA, Uyehara CF. Vasopressin decreases pulmonary-to-systemic vascular resistance ratio in a porcine model of severe hemorrhagic shock. Shock. 2015;43:475–82.

    Article  CAS  Google Scholar 

  3. Barnes L, Reed RM, Parekh KR, Bhama JK, Pena T, Rajagopal S, Schmidt GA, Klesney-Talt JA, Eberlein M. Mechanical ventilation for the lung transplant recipient. Curr Pulmonol Rep. 2015;4:88–96.

    Article  Google Scholar 

  4. Verbeek GL, Myles PS, Westall GP, Lin E, Hastings SL, Marasco SF, Jaffar J, Meehan AC. Intra-operative protective mechanical ventilation in lung transplantation: a randomised, controlled trial. Anaesthesia 2017;72:993–1004.

    Google Scholar 

  5. Geube MA, Perez-Protto SE, McGrath TL, Yang D, Sessler DI, Budev MM, Kurz A, McCurry KR, Duncan AE, et al. Increased intraoperative fluid administration is associated with severe primary graft dysfunction after lung transplantation. Anesth Analg. 2016;122(4):1081–8.

    Article  Google Scholar 

  6. Snell GI, Yussen RD, Weill D, Strueber M, Garrity E, Reed A, Pelaez A, Wjelan TP, Perch M, Bag R, Budev M, Corris PA, Crespo MM, Witt C, Cantu E, Christie JD. Report of the ISHLT Working Group on Primary Lung Graft dysfunction, part 1: definition and grading-A 2016 consensus group statement of the International Society of Heart and Lung Transplantation. J Heart Lung Transpl. 2017;36:1097–103.

    Article  Google Scholar 

  7. Machuzak M, Santacruz JF, Gildea T, Murthy SC. Airway complications after lung transplantation. Thorac Surg Clin. 2015;25:55–75.

    Article  Google Scholar 

  8. Bottero S, Meucci D, Trozzi M, Carotti A. Dehiscence of bronchial anastomosis after lung transplantation: a successful unconventional treatment. Ann Thorac Surg. 2018;106:e81–3.

    Article  Google Scholar 

  9. Levine DJ, Glanville AR, Aboyoun C, Belperio J, Benden C, Berry GJ, Hachem R, Hayes D Jr, Neil D, Reinsmoen NL, Snyder LD, Sweet S, Tyan D, Verleden G, Westall G, Yusen RD, Zamora M, Zeevi A. Antibody-mediated rejection of the lung: a consensus report of the International Society for Heart and Lung Transplantation. J Heart Lung Transpl. 2016;35:397–406.

    Article  Google Scholar 

  10. Magouliotis DE, Tasiopoulou VS, Svokos AA, Svokos KA, Zacharoulis D. Extracorporeal membrane oxygenation versus cardiopulmonary bypass during lung transplantation: a meta-analysis. Gen Thorac Cardiovasc Surg. 2018;66:38–47.

    Article  Google Scholar 

  11. Mohite PN, Sabashnikov A, Patil NP, Garcia-Saez D, Zych B, Zeriouh M, Romano R, Soresi S, Reed A, Carby M, De Robertis F, Bahrami T, Amrani M, Marczin N, Simon AR, Popov AF. The role of cardiopulmonary bypass in lung transplantation. Clin Transpl. 2016;30:202–9.

    Article  Google Scholar 

  12. Dzierba AL, Abrams D, Brodie D. Medicating patients during extracorporeal membrane oxygenation; the evidence is building. Crit Care. 2017;21:66.

    Article  Google Scholar 

  13. Lemaitre F, Hasni N, Leprince P, Corvol E, Belhabib G, Fillâtre P, Luyt CE, Leven C, Farinotti R, Fernandez C, Combes A. Propofol, midazolam, vancomycin and cyclosporine therapeutic drug monitoring in extracorporeal membrane oxygenation circuits primed with whole human blood. Crit Care. 2015;19:40.

    Article  Google Scholar 

  14. Parasuraman S, Walker S, Loudon BL, Gollop ND, Wilson AM, Lowery C, Frenneaux MP. Assessment of pulmonary artery pressure by echocardiography-A comprehensive review. Int J Cardiol Heart Vasc. 2016;12:45–51.

    PubMed  PubMed Central  Google Scholar 

  15. Rajagopal K, Griffith BP. Oxford textbook of critical care. 2nd ed. UK: Oxford University Press; 2016.

    Google Scholar 

  16. Porteous MK, Ky B, Kirkpatrick JN, Shinohara R, Diamond JM, Shah RJ, Lee JC, Christie JD, Kawut SM. Diastolic dysfunction increases the risk of primary graft dysfunction after lung transplant. Am J Respir Crit Care Med. 2016;193:1392–400.

    Article  Google Scholar 

Further Reading and Related Links/Journals/Book

  1. Holmes CL, Landry DW, Granton JT. science review: vasopressin and the cardiovascular system part 2—clinical physiology. Crit Care. 2004;1:15–23.

    Article  Google Scholar 

  2. Noguera I, Medina P, Segarra G, Martínez MC, Aldasoro M, Vila JM, Lluch S. Potentiation by vasopressin of adrenergic vasoconstriction in the rat isolated mesenteric artery. Br J Pharmacol. 1997;122:431–8.

    Article  CAS  Google Scholar 

  3. Maybauer MO, Maybauer DM, Enkhbaatar P, Laporte R, Wiśniewska H, Traber LD, Lin CD, Fan J, Hawkins HK, Cox RA, Wiśniewski K, Schteingart CD, Landry DW, Rivière PJ, Traber DL. The selective vasopressin type 1a receptor agonist selepressin (FE202158) blocks vascular leak in ovine severe sepsis. Crit Care Med. 2014;42:e525–33.

    Article  CAS  Google Scholar 

  4. Evora PR, Pearson PJ, Schaff HV. Arginine vasopressin induces endothelium-dependent vasodilatation of the pulmonary artery. V1-receptor-mediated production of nitric oxide. Chest. 1993;103:1241–1245.

    Google Scholar 

  5. Mascia L, Pasero D, Slutsky AS, Arguis MJ, Berardino M, Grasso S, Munari M, Boifava S, Cornara G, Della Corte F, Vivaldi N, Malacarne P, Del Gaudio P, Livigni S, Zavala E, Filippini C, Martin EL, Donadio PP, Mastromauro I, Ranieri VM. Effect of a lung protective strategy for organ donors on eligibility and availability of lungs for transplantation: a randomize controlled trial. JAMA. 2010;304:2620–7.

    Article  CAS  Google Scholar 

  6. Christie JD, Van Raemdonck D, de Perrot M, Barr M, Keshavjee S, Arcasoy S, Orens J. Report of the ISHL Working Group on Primary Lung Graft dysfunction Part II: definition. A consensus Statement of the International Society of Heart and Lung Transplantation. J Heart Lung Transpl. 2005;24:1451–1459.

    Google Scholar 

  7. Lee JC, Christie JD. Primary graft dysfunction. Clin Chest Med. 2011;32:279–93.

    Article  Google Scholar 

  8. Shah RJ, Bellamy SL, Localio AR, Wickersham N, Diamond JM, Weinacker A, Lama VN, Bhorade S, Belperio JA, Crespo M, Demissie E, Kawut SM, Wille KM, Lederer DJ, Lee JC, Palmer SM, Orens J, Reynolds J, Shah A, Wilkes DS, Ware LB, Christie JD. A panel of lung injury biomarkers enhances the definition of primary graft dysfunction (PGD) after lung transplantation. J Heart Lung Transpl. 2012;31:942–9.

    Article  Google Scholar 

  9. Suzuki Y, Cantu E, Christie JD. Primary graft dysfunction. Semin Respir Crit Care Me. 2013;34:305–19.

    Article  Google Scholar 

  10. Ray M, Dharmarajan S, Freudenberg J, Zhang W, Patterson GA. Expression profiling of human donor lungs to understand primary graft dysfunction after lung transplantation. Am J Transpl. 2007;7:2396–405.

    Article  CAS  Google Scholar 

  11. Fischer S, Cassivi SD, Xavier AM, Cardella JA, Cutz E, Edwards V, Liu M, Keshavjee S. Cell death in human lung transplantation: apoptosis induction in human lungs during ischemia and after transplantation. Ann Surg. 2000;231:424–31.

    Article  CAS  Google Scholar 

  12. Diamond JM, Lee JC, Kawut SM, Shah RJ, Localio AR, Bellamy SL, Lederer DJ, Cantu E, Kohl BA, Lama VN, Bhorade SM, Crespo M, Demissie E, Sonett J, Wille K, Orens J, Shah AS, Weinacker A, Arcasoy S, Shah PD, Wilkes DS, Ware LB, Palmer SM, Christie JD, Lung Transplant Outcomes Group. Clinical risk factors for primary graft dysfunction after lung transplantation. Am J Respir Crit Care Med 2013;187:527–534.

    Google Scholar 

  13. Schulman LL, Anandarangam T, Leibowitz DW, Ditullio MR, McGregor CC, Galantowicz ME, Homma S. Four-year prospective study of pulmonary venous thrombosis after lung transplantation. J Am Soc Echocardiogr. 2001;14:806–12.

    Article  CAS  Google Scholar 

  14. Christie JD, Carby M, Bag R, Corris P, Hertz M, Weill D. Report of the ISHL Working Group on Primary Lung Graft dysfunction Part II: definition. A consensus Statement of the International Society of Heart and Lung Transplantation. J Heart Lung Transplant 2005;24:1451–1459.

    Google Scholar 

  15. De Gracia J, Culebras M, Alvarez A, Catalán E, De la Rosa D, Maestre J, Canela M, Román A. Bronchoscopic balloon dilatation in the management of bronchial stenosis following lung transplantation. Respir Med. 2007;101:27–33.

    Article  Google Scholar 

  16. Lobo LJ, Aris RM, Schmitz J, Neuringer IP. Donor-specific antibodies are associated with antibody-mediated rejection, acute cellular rejection bronchiolitis obliterans syndrome, and cystic fibrosis after lung transplantation. J Heart Lung Transpl. 2013;32:70–7.

    Article  Google Scholar 

  17. Hachem RR, Yusen RD, Meyers BF, Aloush AA, Mohanakumar T, Patterson GA, Trulock EP. Anti-human leukocyte antigen antibodies and preemptive antibody-directed therapy after lung transplantation. J Heart Lung Transpl. 2010;29:973–80.

    Article  Google Scholar 

  18. Shekar K, Fraser JF, Smith MT, Roberts JA. Pharmacokinetic changes in patients receiving extracorporeal membrane oxygenation. J Crit Care. 2012;27(741):e9–18.

    Google Scholar 

  19. Wagner D, Pasko D, Phillips K, Waldvogel J, Annich G. In vitro clearance of dexmedetomidine in extracorporeal membrane oxygenation. Perfusion. 2013;28:40–6.

    Article  CAS  Google Scholar 

  20. Liu N, Chazot T, Trillat B, Michel-Cherqui M, Marandon JY, Law-Koune JD, Rives B, Fischler M; Foch Lung Transplant Group. Closed-loop control of consciousness during lung transplantation: an observational study. J Cardiothorac Vasc Anesth 2008;22:611–615.

    Google Scholar 

  21. González-Fernández C, González-Castro A, Rodríguez-Borregán JC, López-Sánchez M, Suberviola B, Francisco Nistal J, Martín-Durán R. Pulmonary venous obstruction after lung transplantation. Diagnostic advantages of transesophageal echocardiography. Clin Transpl. 2009;23:975–980.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Eric E. C. de Waal

  2. Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, Weill Cornell Medical Center, New York, USA

    Bessie Kachulis

  3. Division of Adult Cardiothoracic Anesthesiology, Department of Anesthesiology, Perioperative Care & Pain Medicine, NYU Langone Health New York, New York, USA

    Liliya Pospishil

  4. Section of Anaesthesia, Pain Medicine and Intensive Care, Imperial College, London, UK

    Nandi Marczin

  5. Department of Anaesthetics, The Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Harefield, UK

    Nandi Marczin

  6. Department of Anaesthesia and Intensive Care, Semmelweis University, Budapest, Hungary

    Nandi Marczin

Authors
  1. Eric E. C. de Waal
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  2. Bessie Kachulis
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  3. Liliya Pospishil
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  4. Nandi Marczin
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Corresponding author

Correspondence to Bessie Kachulis .

Editor information

Editors and Affiliations

  1. “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania

    Claudiu E. Nistor

  2. Royal Papworth Hospital, Cambridge, UK

    Steven Tsui

  3. Koşuyolu Heart and Research Hospital, Istanbul, Turkey

    Kaan Kırali

  4. “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania

    Adrian Ciuche

  5. Royal Papworth Hospital, Cambridge, UK

    Giuseppe Aresu

  6. The University Hospital of Bern, Bern, Switzerland

    Gregor J. Kocher

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de Waal, E.E.C., Kachulis, B., Pospishil, L., Marczin, N. (2020). Anesthesia in Lung Transplantation. In: Nistor, C.E., Tsui, S., Kırali, K., Ciuche, A., Aresu, G., Kocher, G.J. (eds) Thoracic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-40679-0_80

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  • DOI: https://doi.org/10.1007/978-3-030-40679-0_80

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  • Online ISBN: 978-3-030-40679-0

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