A Comment on Pretransplant Management of the Potential Lung Recipient
The general principles of management of a patient with severe pulmonary disease apply equally to those patients who are being evaluated, or who are currently on the waiting list for lung transplantation (LTx). These principles are well known to the pulmonologist and will not be repeated here. In addition, a major objective of medical management of LTx candidates is to keep the patient in an optimal nutritional and physiologic condition prior to transplantation. Medications should be avoided which might have adverse effects on the patient at the time of surgery, or cause problems with toxicity and end-organ damage. Examples include corticosteroids and drugs which result in nephrotoxicity or fluid retention. The principles of good nutrition and maintenance of near-normal ideal body weight apply to these patients, since either excessive or inadequate body weight may adversely affect their ability to undergo the transplant with an acceptable risk. Physical rehabilitation in an exercise program several times a week is mandatory for all LTx candidates to optimize their muscular strength and endurance.