ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

ANESTHETIC MANAGEMENT IN LUNG TRANSPLANTATION

Hülya Yiğit Özay

Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation, Ankara, Türkiye

Yiğit Özay H. Anesthetic Management in Lung Transplantation. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.393-402.

ABSTRACT

Lung transplantation has been the only known treatment option for end-stage lung diseases and has been successfully used for nearly 40 years. Although more lung transplants are performed each year, potential donor shortages are causing recipients to wait longer on transplant lists. When patients come for transplantation, they will probably come to surgery with a more complex picture such as pulmonary hypertension, right ventricular dysfunction, bridge to transplantation. Potential recipient candidates need multidisciplinary care in the perioperative period. This process is quite challenging for the anesthesiologist.

Keywords: Lung transplantation; Extracorporeal membrane oxygenation; Airway management; Reperfusion injury; Primary graft dysfunction

Referanslar

  1. Kim HJ, Shin SW, Park S, Kim HY. A Review of Anesthesia for Lung Transplantation. J Chest Surg. 2022;55(4):293- 300. [Crossref]  [PubMed]  [PMC]
  2. Hardy JD, Webb WR, Dalton ML, Jr, Walker GR, Jr. Lung homotransplantation in man. JAMA. 1963;186:1065-1074. [Crossref]  [PubMed]
  3. Toronto Lung Transplant Group, author. Unilateral lung transplantation for pulmonary fibrosis. N Engl J Med. 1986;314:1140-1145. [Crossref]  [PubMed]
  4. Martin AK, Yalamuri SM, Wilkey BJ, Fritz AV, Jayaraman A, Ramakrishna H, et al. The Impact of Anesthetic Management on Perioperative Outcomes in Lung Transplantation J Cardiothorac Vasc Anesth. 2020;34(6):1669-1680. [Crossref]  [PubMed]
  5. Yusen RD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Dobbels F, et al. The registry of the International Society for Heart and Lung Transplantation: thirty-first adult lung and heart-lung transplant report--2014; focus theme: retransplantation. J Heart Lung Transplant. 2014;33:1009-24. [Crossref]  [PubMed]
  6. Weill D, Benden C, Corris PA, Dark JH, Davis RD, Keshavjee S, et al. A consensus document for the selection of lung transplant candidates: 2014-an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant.2015;34(1):1-15. [Crossref]  [PubMed]
  7. Valapour M, Skeans MA, Smith JM, Edwards LB, Cherikh WS, Uccellini K, et al. OPTN/SRTR 2015 Annual Data Report: Lung. Am J Transplant . 2017;17(1):357-424. [Crossref]  [PubMed]
  8. Alina Nicoara, John Anderson-Dam. Anesthesia for Lung Transplantation. Anesthesiology Clin.2017;35:473-489. [Crossref]  [PubMed]
  9. Weill D. Lung transplantation: indications and contraindications. J Thorac Dis. 2018;10: 4574-4587. [Crossref]  [PubMed]  [PMC]
  10. Kumar A, Sharma S, Anjum F. Lung Transplantation. 2024 Jun 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. [Link]
  11. Leard LE, Holm AM, Valapour M, Glanville AR, Attawar S, Aversa M, et al. Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2021;40:1349-1379. [Crossref]  [PubMed]  [PMC]
  12. Gray AL, Mulvihill MS, Hartwig MG. Lung Transplantation at Duke. J Thorac Dis. 2016;8(3):185-196. [Crossref]  [PubMed]  [PMC]
  13. Miranda A, Zink R, McSweeney M. Anesthesia for lung transplantation. Semin Cardiothorac Vasc Anesth. 2005;9(3):205-212. [Crossref]  [PubMed]
  14. Feltracco P, Barbieri S, Milevoj M, Serra E, Michieletto E, Carollo C, et al. Thoracic epidural analgesia in lung transplantation. Transplant Proc. 2010;42(4):1265-1269. [Crossref]  [PubMed]
  15. Yu Y , Zhang K , Zhang L , Zong H . Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults. Cochrane Database Syst. Rev. 2018;1(1):CD010947. [Crossref]  [PubMed]
  16. Thudium M, Heinze I, Ellerkmann RK, Hilbert T. Cerebral Function and Perfusion during Cardiopulmonary Bypass: A Plea for a Multimodal Monitoring Approach. Heart Surg Forum. 2018;21(1):028-035. [Crossref]  [PubMed]
  17. Suehiro K, Tanaka K, Matsuura T, Funao T, Yamada T, Mori T, et al. The Vigileo Flo-Trac™ system: arterial waveform analysis for measuring cardiac output and predicting fluid responsiveness: a clinical review. J Cardiothorac Vasc Anesth 2014;28(5):1361-1374. [Crossref]  [PubMed]
  18. Baez B, Castillo M. Anesthetic considerations for lung transplantation. Semin Cardiothorac Vasc Anesth 2008;12:122-127. [Crossref]  [PubMed]
  19. Michel-Cherqui M, Brusset A, Liu N, Raffin L, Schlumberger S, Ceddaha A, et al. Intraoperative transesophageal echocardiographic assessment of vascular anastomoses in lung transplantation. A report on 18 cases. Chest. 1997;111(5):1229-35. [Crossref]  [PubMed]
  20. Fritz AV, Teixeira MT, Patel SJ, Burtoft M, Martin AK. Update in lung transplantation: anesthetic considerations. Ann Transl Med. 2023;11(11):389. [Crossref]  [PubMed]  [PMC]
  21. Mahuca TN, Collaud S, Mercier O, Cheung M, Cunningham V, Kim SJ, et al. Outcomes of intraoperative extracorporeal membrane oxygenation versus cardiopulmonary bypass for lung transplantation. J Thorac Cardiovasc Surg 2015;149(4):1152-1157. [Crossref]  [PubMed]
  22. Moreno Garijo J, Cypel M, McRae K, Machuca T, Cunningham V, Slinger P. The evolving role of extracorporeal membrane oxygenation in lung transplantation: implications for anesthetic management. J Cardiothorac Vasc Anesth. 2019;33:1995-2006. [Crossref]  [PubMed]
  23. Kachulis B, Mitrev L, Jordan D. Intraoperative anesthetic management of lung transplantation patients. Best Pract Res Clin Anaesthesiol. 2017;31:261-272. [Crossref]  [PubMed]
  24. Nicoara A, Anderson-Dam J. Anesthesia for Lung Transplantation. Anesthesiol Clin.2017;35:473-489. [Crossref]  [PubMed]
  25. Fischer LG, Van Aken H, Burkle H. Management of pulmonary hypertension: physiological and pharmacological considerations for anesthesiologists. Anesth Analg 2003;96(6):1603-1616. [Crossref]  [PubMed]
  26. Rich GF, Roos CM, Anderson SM, Daugherty MO, Uncles DR. Direct effects of intravenous anesthetics on pulmonary vascular resistance in the isolated rat lung. Anesth Analg.1994;78(5):961-6. [Crossref]  [PubMed]
  27. Myles PS, Weeks AM, Buckland MR, Silvers A, Bujor M, Langley M. Anesthesia for bilateral sequential lung transplantation: experience of 64 cases. J Cardiothorac Vasc Anesth. 1997;11:177-183. [Crossref]  [PubMed]
  28. Gold J, Cullinane S, Chen J, Seo S, Oz MC, Oliver JA, et al. Vasopressin in the treatment of milrinone-induced hypotension in severe heart failure. Am J Cardiol. 2000;85(4):506-8, A11. [Crossref]  [PubMed]
  29. Lahm T, McCaslin CA, Wozniak TC, Ghumman W, Fadl YY, Obeidat OS, et al. Medical and surgical treatment of acute right ventricular failure. J Am Coll Cardiol. 2010;56(18):1435-46. [Crossref]  [PubMed]
  30. Russell WJ. A logical approach to the selection and insertion of double-lumen tubes. Curr. Opin. Anaesthesiol.2008;21(1):37-40. [Crossref]  [PubMed]
  31. Kachulis B, Mitrev L, Jordan D. Intraoperative anesthetic management of lung transplantation patients. Best Pract. Res Clin. Anaesthesiol.2017;31(2):261-272. [Crossref]  [PubMed]
  32. Hayanga JW, D'Cunha J. The surgical technique of bilateral sequential lung transplantation. J Thorac Dis. 2014;6(8):1063-9. [PubMed]
  33. Pruszkowski O, Dalibon N, Moutafis M, Jugan E, LawKoune JD, Laloë PA, et al. Effects of propofol vs sevoflurane on arterial oxygenation during one-lung ventilation. Br J Anaesth. 2007;98(4):539-44. [Crossref]  [PubMed]
  34. Yoo YC. Anesthetic considerations for lung transplantation. Anesth. Pain Med. 2019;14(3):241-248. [Crossref]
  35. Schulte-Sasse U, Hess W, Tarnow J. Pulmonary vascular responses to nitrous oxide in patients with normal and high pulmonary vascular resistance. Anesthesiology 1982;57(1):9-13. [Crossref]  [PubMed]
  36. Rosenberg AL, Rao M, Benedict PE. Anesthetic implications for lung transplantation. Anesthesiol Clin North America 2004;22(4):768-788. [Crossref]  [PubMed]
  37. Chetham PM. Anesthesia for heart or single or double lung transplantation in the adult patient. J Card Surg 2000;15(3):167-174. [Crossref]  [PubMed]
  38. Cason M, Naik A, Grimm JC, Hanna D, Faraone L, Brookman JC, et al. The efficacy and safety of epidural-based analgesia in a case series of patients undergoing lung transplantation. J Cardiothorac Vasc Anesth 2015;29(1):126-132. [Crossref]  [PubMed]
  39. Verbeek GL, Myles PS. Intraoperative protective ventilation strategies in lung transplantation.Transplant Rev(Orlando) 2013;27(1):30-5. [Crossref]  [PubMed]
  40. Lugancelo U, Del SL, Boffini M, Marco RV. Protective ventilation for lung transplantation.Curr Opin Anaesthesiol 2012;25(2):170-4. [Crossref]  [PubMed]
  41. Lohser J, Slinger P. Lung injury after one-lung ventilation: a review of the pathophysiologic mechanisms affecting the ventilated and the collapsed lung. Anesth Analg 2015;121(2):302-318. [Crossref]  [PubMed]
  42. Mascia L, Pasero D, Slutsky AS, Arguis MJ, Berardino M, Grasso S, et al. Effect of a lung protective strategy for organ donors on eligibility and availability of lungs for transplantation: a randomized controlled trial.JAMA 2010;304(23):2620-2627. [Crossref]  [PubMed]
  43. Chen-Yoshikawa TF. Ischemia-Reperfusion Injury in Lung Transplantation. Cells. 2021;10(6):1333. [Crossref]  [PubMed]  [PMC]
  44. Hengst WA, Gielis JF, Lin JY, Van Schil PE, De Windt LJ, Moens AL. Lung ischemia-reperfusion injury: a molecular and clinical view on a complex pathophysiological process. Am J Physiol Heart Circ Physiol 2010;299(5):H1283-299. [Crossref]  [PubMed]
  45. Thabut G, Brugiere O, Leseche G, Stern JB, Fradj K, Herve P, et al. Preventive effect of inhaled nitric oxide and pentoxifilline on ischemia/repefusion injury after lung transplantation. Transplantation 2001;71(9):1295-1300. [Crossref]  [PubMed]
  46. Acute Respiratory Distress Syndrome Network; Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342(18):1301-1308. [Crossref]  [PubMed]
  47. Sugita M, Ferraro P, Dagenais A, Clermont ME, Barbry P, Michel RP, et al. Alveolar fluid clearance and sodium channel expression are decreased in transplanted canine lungs. Am J Respir Crit Care Med 2003;167(10):1440-1450. [Crossref]  [PubMed]
  48. Jing L, Chen W, Zhao L, Guo L, Liang C, Chen J, et al. Acute kidney injury following adult lung transplantation. Chin Med J (Engl). 2021;135-180. [Crossref]  [PubMed]  [PMC]
  49. Duan Q, Zhang Y, Yang D. Perioperative fluid management for lung transplantation is challenging. Helione. 2023;9:e14704. [Crossref]  [PubMed]  [PMC]
  50. Richard C, Girard F, Ferraro P, Chouinard P, Boudreault D, Ruel M, et al. Acute postoperative pain in lung transplant recipients. Ann Thorac Surg.2004;77:1951-1955. [Crossref]  [PubMed]
  51. Cason M, Naik A, Grimm JC, Hanna D, Faraone L, Brookman JC, et al. The efficacy and safety of epidural-based analgesia in a case series of patients undergoing lung transplantation. J Cardiothorac Vasc Anesth. 2015;29:126-132. [Crossref]  [PubMed]