Techniques in Lung Transplantation
Lung transplantation remains the gold standard therapy for patients suffering from end-stage lung disease, providing quality of life and prognostic benefits in otherwise severely debilitating, if not imminently fatal conditions. This chapter discusses some of the most conventional techniques of lung transplantation, including on and off cardiopulmonary bypass approaches and use of perioperative venoarterial and venovenous extracorporeal membrane oxygenation (ECMO). The aim of preoperative workup is to identify appropriate lung transplantation recipients by closely evaluating for the presence of concomitant pathologies involving other organ systems as well as psychosocial factors that might prevent a successful transplant outcome. As most patients are not on the ventilator and/or ECMO preoperatively, thorough preoxygenation prior to induction of anesthesia is paramount. As in any operation, patient positioning is key to the smooth conduct of lung transplantation surgery.
