Lung Transplantation

  • Mike Mulligan


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.


Lung transplant Clamshell incision Donor management Cardiopulmonary bypass Tips Tricks 


  1. 1.
    Yusen RD, Edwards LB, Kucheryavaya AY, 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.CrossRefPubMedGoogle Scholar
  2. 2.
    Hertz M, Taylor D, Trulock E, et al. The Registry of the International Society for Heart and Lung Transplantation: nineteenth official report—2002. J Heart Lung Transplant. 2002;21:950–70.CrossRefPubMedGoogle Scholar
  3. 3.
    Fisher AJ, Dark JH, Corris PA. Improving donor lung evaluation: a new approach to increase organ supply for lung transplantation. Thorax. 1998;53:818–20.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Sundaresan S, Trachiotis GD, Aoe M, et al. Donor lung procurement: assessment and operative technique. Ann Thorac Surg. 1993;56:1409–13.CrossRefPubMedGoogle Scholar
  5. 5.
    Sundaresan S, Semenkovich J, Ochoa L, et al. Successful outcome of lung transplantation is not compromised by the use of marginal donor lungs. J Thorac Cardiovasc Surg. 1995;109:1075–80.CrossRefPubMedGoogle Scholar
  6. 6.
    Wood K, Becker B, McCartney J, et al. Care of the potential organ donor. N Engl J Med. 2004;351:2730–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Alvarez A, Moreno P, Espinosa D, et al. Assessment of lungs for transplantation: a stepwise analysis of 476 donors. Eur J Cardiothorac Surg. 2010;37(2):432–9.PubMedGoogle Scholar
  8. 8.
    Bhorade A, Vigneswaran W, Mccabe M, Garrity M. Liberalization of donor criteria may expand the donor pool without adverse consequence in lung transplantation. J Heart Lung Transplant. 2000;19:1199–204.CrossRefPubMedGoogle Scholar
  9. 9.
    Fitzsullivan E, Gries CJ, Phelan P, et al. Reduction in airway complications after lung transplantation with novel anastomotic technique. Ann Thorac Surg. 2011;92(1):309–15.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of WashingtonSeattleUSA

Personalised recommendations