Acute Crit Care.  2018 Nov;33(4):197-205. 10.4266/acc.2018.00367.

Critical Care before Lung Transplantation

Affiliations
  • 1Department of Thoracic and Cardiovascular, Yonsei University College of Medicine, Seoul, Korea. HCPAIK@yuhs.ac
  • 2Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

Keyword

critical care; donor selection; extracorporeal life support; lung transplantation; mechanical ventilation; preoperative care; transplant recipients

MeSH Terms

Critical Care*
Donor Selection
Humans
Intensive Care Units
Lung Diseases
Lung Transplantation*
Lung*
Preoperative Care
Respiration, Artificial
Tissue Donors
Transplant Recipients
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