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Review
. 2019 Sep;11(Suppl 14):S1782-S1788.
doi: 10.21037/jtd.2019.05.60.

Postoperative management of lung transplant recipients

Christina C Kao  1 , Amit D Parulekar  1
Affiliations
Review

Postoperative management of lung transplant recipients

Christina C Kao et al. J Thorac Dis. 2019 Sep.

Abstract

Despite advances in surgical technique, lung transplantation is associated with worse survival when compared with other solid organ transplantations. Graft dysfunction and infection are the leading causes of mortality in the first 30 days following transplantation. Primary graft dysfunction (PGD) is a form of reperfusion injury that occurs early after transplantation. Management of PGD is mainly supportive with use of lung protective ventilation. Inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation may be used in severe cases. Bacterial pneumonias are the most common infectious complication in the immediate post transplant period, but invasive fungal infections may also occur. Other potential complications in the postoperative period include atrial arrhythmias and neurologic complications such as stroke. There is a lack of multicenter, randomized trials to guide ventilation strategies, infection prophylaxis, and treatment of atrial arrhythmias, therefore prevention and management of post-transplant complications vary by transplant center.

Keywords: Primary graft dysfunction (PGD); arrhythmia; ventilation.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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