Pediatric recipients of living donor lobar lung transplants: postoperative care.
Bilateral living donor lobar lung transplantation is a treatment option for selected children and adults with end-stage lung disease. Careful donor evaluation, skilled intraoperative management and surgical technique, and diligent immediate postoperative care and follow-up all contribute to better outcomes. Although medical management of whole lung transplant recipients in the immediate postoperative period is similar to that of lobar lung transplant recipients, there are specific differences. Anatomical distinctions, such as the entire cardiac output flowing to 2 lobes instead of 5, and thoracic space issues with simultaneous mechanical ventilation and chest tube suction, contribute to these differences. Early postoperative care, including initial postoperative stabilization, ventilation, fluid management, rejection/infection surveillance and prophylaxis, and beginning rehabilitation, can be adapted to ensure successful outcomes in these patients.
Childrens Hospital Los Angeles, Calif., USA.
Monica V
MV
Horn
Felicia A
FA
Schenkel
Marlyn S
MS
Woo
Vaughn A
VA
Starnes
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D019520:Living Donors; D008171:Lung Diseases / Q000601:surgery*; D016040:Lung Transplantation / Q000592:standards*; D008297:Male; D011182:Postoperative Care / Q000592:standards*; D014180:Transplantation / Q000592:standards*