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Chapter 37 - Lung Transplantation

from Section 6 - Heart Failure, Mechanical Circulatory Support, and Transplantation

Published online by Cambridge University Press:  09 September 2021

By
Arpa Chutipongtanate  and
Erica P. Lin
Edited by
Laura K. Berenstain  and
James P. Spaeth
Laura K. Berenstain
Affiliation:
Cincinnati Children's Hospital Medical Center
James P. Spaeth
Affiliation:
Cincinnati Children's Hospital Medical Center
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Summary

Pediatric lung transplantation is the most aggressive therapeutic option for children with end-stage pulmonary disease, but it remains a relatively rare operation. Major diagnoses necessitating transplant vary according to recipient age group. Cystic fibrosis is the most common indication in children ?6 years, while pulmonary hypertension and surfactant disorders account for the majority of cases in infants 1 year of age. Lungs are unique in that they remain directly exposed to the external environment with its infective and immunologic challenges and therefore high levels of immunosuppression are required. Acute rejection affects the majority of lung transplant recipients and typically is seen during the first 3 months post transplantation. It may be asymptomatic or present with nonspecific symptoms mimicking infection, including cough, fever, hypoxemia, tachypnea, or dyspnea. This chapter discusses the perioperative management of a patient post lung transplantation with symptomatology for diagnostic evaluation.

Keywords

anesthesiabronchiolitis obliteransbronchoscopypediatric lung transplantation
Type
Chapter
Information
Congenital Cardiac Anesthesia
A Case-based Approach
 , pp. 283 - 289
Publisher: Cambridge University Press
Print publication year: 2021

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References

References

Goldfarb, S. B., Hayes, D. Jr., Levvey, B. J., et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: twenty-first Pediatric Lung and Heart-Lung Transplantation Report-2018; focus theme: Multiorgan Transplantation. J Heart Lung Transplant 2018; 37: 1196–206.CrossRefGoogle ScholarPubMed
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Suggested Reading

Bryant, R. III, Morales, D., Schecter, M. Pediatric lung transplantation. Semin Pediatr Surg 2017; 26: 213–16.CrossRefGoogle ScholarPubMed
Feltracco, P., Falasco, G., Barbieri, S., et al. Anesthetic considerations for nontransplant procedures in lung transplant patients. J Clin Anesth 2011; 23: 508–16.CrossRefGoogle ScholarPubMed
LaRosa, C., Glah, C., Baluarte, H. J., et al. Solid-organ transplantation in childhood: transitioning to adult health care. Pediatrics 2011; 127: 742–53.Google Scholar

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