Combined Thoracic and Abdominal Organ Transplantation: Special Considerations

Abstract

Combined thoracic-abdominal organ transplants are infrequently performed procedures indicated for patients with failure of two or more transplantable organs. In this review, we discuss recipient selection, surgical considerations, anesthetic management, and outcomes associated with common combinations of thoracic-abdominal transplant operations. General principles regarding the postoperative care of these patients are also discussed. These procedures present a unique challenge requiring specialized knowledge, technical expertise, and leadership from the anesthesiology team throughout the perioperative period.

Keywords: amyloidosis; cardiothoracic ICU; cirrhosis; combined organ transplantation; cystic fibrosis; familial hypercholesterolemia; heart failure; heart transplantation; hemochromatosis; kidney transplantation; liver transplantation; lung transplantation; α-1 antitrypsin deficiency.