Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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A Review of Anesthesia for Lung Transplantation

  • Kim, Hye-Jin (Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital) ;
  • Shin, Sang-Wook (Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital) ;
  • Park, Seyeon (Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital) ;
  • Kim, Hee Young (Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital)
  • Received : 2022.06.29
  • Accepted : 2022.07.18
  • Published : 2022.08.05
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Abstract

Lung transplantation is the only treatment option for patients with end-stage lung disease. Although more than 4,000 lung transplants are performed every year worldwide, the standardized protocols contain no guidelines for monitoring during lung transplantation. Specific anesthetic concerns are associated with lung transplantation, especially during critical periods, including anesthesia induction, the initiation of positive pressure ventilation, the establishment and maintenance of one-lung ventilation, pulmonary artery clamping, pulmonary artery unclamping, and reperfusion of the transplanted lung. Anesthetic management according to the special risks associated with a patient's existing lung disease and surgical stage is the most important factor. Successful anesthesia in lung transplantation can improve hemodynamic stability, oxygenation, ventilation, and outcomes. Therefore, anesthesiologists must have expertise in transesophageal echocardiography, extracorporeal life support, and cardiopulmonary anesthesia and understand the pathophysiology of end-stage lung disease and the drugs administered. In addition, communication among anesthesiologists, surgeons, and perfusionists during surgery is important to achieve optimal patient results.

Keywords

Acknowledgement

This work was supported by a 2022 research grant from Pusan National University Yangsan Hospital.

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