Acute Crit Care.  2018 Nov;33(4):206-215. 10.4266/acc.2018.00360.

Critical Care after Lung Transplantation

• Kim SY
• Jeong SJ
• Lee JG
• Park MS
• Paik HC
• Na S
• Kim J

• KMID: 2441237
• DOI: http://doi.org/10.4266/acc.2018.00360

Abstract

Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.

Keyword

critical care; immunosuppression; lung transplantation; postoperative care; postoperative complications; preventive care; transplant rejection; transplantation immunology

MeSH Terms

Critical Care*
Graft Rejection
Heart
Immunosuppression
Intensive Care Units
Length of Stay
Lung Transplantation*
Lung*
Mortality
Postoperative Care
Postoperative Complications
Reperfusion Injury
Respiration, Artificial
Transplantation Immunology

Figure

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  Figure 1. Gauzes were packed to control postoperative bleeding.

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  Figure 2. Bronchopleural fistula (BPF). (A) Fiberoptic bronchoscopy (FOB) finding of BPF (arrows). (B) Suddenly developed pneumothorax and subcutaneous emphysema on chest X-ray. (C) FOB finding showing repaired BPF with omental flap. (D) Chest X-ray after BPF repair with omental flap.

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  Figure 3. Pulmonary artery stenosis. (A) Pulmonary angiography shows nearly total obstruction (kinking) of left main pulmonary artery. (B) A stent was inserted on left main pulmonary artery and left pulmonary flow was restored.

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