Lung transplantation: how we do it

Abstract

Lung transplantation is considered the gold standard for patients with chronic end-stage pulmonary disease. However, due to the complexity of management and relatively lower median survival as compared to other solid organs, many programs across the world have been slow to adopt the same. In our institution, we started lung transplantation in September 1990. And since then, we performed close to 900 lung transplantations. Here, we describe in detail the operative steps adopted in our institution for a successful lung transplantation. There have been very few variations over the years. We believe that having a standardized technique is one of the important features for success of a lung transplant program.

Lung Transplantation as a treatment strategy for Pulmonary Emphysema

“…This technique is used by most surgeons because gives less complications. If there is a mismatch between the bronchi a telescopic suture is used by taking smaller bites on the donor aiming to fit the donor bronchus Lung Transplantation as a Treatment Strategy for Pulmonary Emphysema DOI: http://dx.doi.org/10.5772/intechopen.1004832 into the recipient [48]. Afterward, an air leak test is performed, and the anastomosis integrity is checked by intraoperative bronchoscopy.…”

“…Conversely, the antegrade flush begins by slowly releasing the pulmonary artery (PA) clamp, keeping the left atrium (LA) clamp closed, and ultimately releasing the atrial clamp [46]. Clamp is wrapped and fixed to the drape followed by artery opening and preparation for anastomosis [48]. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.…”

“…Figure 2. Right bronchial anastomosis (A) First suture outside-in on recipient at membranous-cartilaginous part (B) Samesuture inside-out in the donor bronchus[48]. Open access this article is licensed under a creative commons attribution 4.0 international license, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the creative commons license, and indicate if changes were made.…”

Surgical treatment in pulmonary hypertension

“…Figure 3.The bronchial, pulmonary artery, and left atrial cuff anastomosis. From Ref [9]. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.…”