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Anesthetic Management for Lung Transplantation

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Anesthesia and Perioperative Care for Organ Transplantation

Abstract

Perioperative management of patients undergoing lung transplantation (LTx) is complex and requires close coordination between anesthesiologists, surgeons, perfusionists, and critical care physicians. Thorough preoperative evaluation, careful anesthesia induction, intensive intraoperative monitoring, meticulous titration of anesthetic and vasoactive medications, and clear communication with the surgical and postoperative care team are essential. LTx is now most frequently performed without extracorporeal support, requiring patients with end-stage lung disease to be subjected to extended periods of one-lung ventilation. The decision to implement extracorporeal support is a clinical one, taking into account preoperative information and intraoperative stability. Intraoperative transesophageal echocardiography plays an important role in hemodynamic management and the early detection and management of complications. Primary graft dysfunction is a common source of morbidity and mortality and requires optimal supportive care by the peri-operative team. Postoperative pain management with epidural block may facilitate recovery after LTx.

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Authors and Affiliations

  1. Department of Anesthesiology, Presbyterian Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Michael L. Boisen M.D. & Kathirvel Subramaniam M.D., M.P.H.

  2. Department of Anesthesiology, Memorial Regional Hospital, Hollywood, FL, USA

    Andréa R. Xavier M.D.

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  1. Michael L. Boisen M.D.
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  2. Andréa R. Xavier M.D.
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  3. Kathirvel Subramaniam M.D., M.P.H.
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Correspondence to Michael L. Boisen M.D. .

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Editors and Affiliations

  1. Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

    Kathirvel Subramaniam

  2. Department of Anesthesiology The Clinical and Translational Science Institute The McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Tetsuro Sakai

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Boisen, M.L., Xavier, A.R., Subramaniam, K. (2017). Anesthetic Management for Lung Transplantation. In: Subramaniam, K., Sakai, T. (eds) Anesthesia and Perioperative Care for Organ Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6377-5_9

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