Postoperative Care of the Lung Transplant Patient
The early postoperative management of recipients of a lung transplant has changed dramatically since the first successful reports of these operations in the early 1980s. Patients were usually placed in reverse isolation and subjected to mechanical ventilation for days. Staff physicians rarely left the bedside. Twenty years later, new transplant recipients are handled much like other patients in the surgical intensive care unit (SICU). The precautions against nosocomial infection are similar, and extubation often occurs on the first day following the transplant. Surgical bleeding is much less common and perioperative death rates have fallen from at least 20% to around 10% (1). Many factors account for this improvement in outcome including the establishment of multidisciplinary care teams, improved selection of transplant candidates, experience and technique refinement by physicians and surgeons, and a better understanding of immunosuppression, infection prophylaxis, and early medical complications. This chapter summarizes the current early management of lung transplant recipients.
KeywordsAcute Rejection Lung Transplant Mycophenolate Mofetil Calcineurin Inhibitor Early Postoperative Period
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