It is our belief that a successful outcome following single- or double-lung transplant is based on proper donor assessment and management, appropriate donor-recipient matching, and performing a technically sound surgery. Therefore, this chapter will discuss some of the “tips” and “tricks” regarding lung transplantation aimed at the practicing surgeon beginning with both donor and recipient assessment and management as well as conduct of the recipient operation.
At our institution, the majority of patients undergo bilateral lung transplant for which our preferred approach is via clamshell incision. Due to our geographic location and relatively limited donor pool, our wait list is longer than at other institutions, and our recipients are frequently quite ill with high lung allocation scores (LAS) at the time of transplant. We, therefore, frequently use cardiopulmonary bypass to perform our transplants. Thus, our discussion of the transplant procedure itself will be reflective of our patient population.
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