[Lung transplantation. State of the art].
Lung transplantation is currently considered an established treatment for some advanced lung diseases. The beginning of experimental lung transplantation dates back to the 1940's when the Soviet Vladimir P. Demikhov performed the first lung transplants in animals. Two decades later, James Hardy performed the first lung transplant in humans. Unfortunately, the beginning of clinical lung transplantation was hampered by technical complications and the excessive toxicity of immunosuppressive drugs. Improvement in the surgical technique along with the development of more effective and less toxic immunosuppressive drugs has led to a better outcome in lunt transplant recipients. Donor selection and management before organ procurement play a key role in the receptor's outcome. Due to the shortage of donors, some institutions are using more liberal selection criteria, reporting satisfactory outcomes. The approach of the lung and heart-lung transplant patient is multidisciplinary and includes the cardiothoracic transplant surgeon, pulmonologist, anesthesiologist, and intensivist, among others. Herein, we review some relevant historical aspects and recent advances in the management of lung transplant recipients, including indications and contraindications, evaluation of donors and recipients, surgical techniques and peripost-operative care.
García-Covarrubias
Lisardo
L
Cirugía de trasplantes cardiotorácicos, Universidad de Miami/Jackson Memorial Hospital, Miami, Florida 33136, EUA. lgarcia8@um-jmh.org
Salerno
Tomas A
TA
Panos
Anthony L
AL
Pham
Si M
SM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000818:Animals; D002170:Canada; D000075202:Contraindications; D046148:Donor Selection; D016041:Heart-Lung Transplantation; D049673:History, 20th Century; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D019520:Living Donors; D016040:Lung Transplantation / Q000009:adverse effects / Q000266:history / Q000379:methods / Q000401:mortality; D008800:Mexico; D008875:Middle Aged; D010348:Patient Care Team; D011182:Postoperative Care; D011183:Postoperative Complications; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D011658:Pulmonary Fibrosis / Q000601:surgery; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014586:USSR; D014481:United States
D007166:Immunosuppressive Agents