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Early Postoperative Management

  • Hartmut Grasemann
  • Melinda Solomon
  • Gary Visner
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Immediately after successful surgery, the pediatric lung transplant recipient will typically be transferred to the intensive care unit (ICU) for postoperative management. Proper monitoring and management during the early postoperative care is critical for both immediate survival and long-term outcome. There are a number of potential complications in the early transplant period that need to be recognized, prevented if possible, and/or treated appropriately. These complications include, but are not limited to problems with mechanical ventilation, hemodynamic instability and cardiovascular problems. The transplanted allograft is at risk for developing pulmonary edema, infection, acute or hyperacute rejection, and possibly transfusion-related acute lung injury. Surgical complications may include bleeding, pulmonary venous thrombosis, problems with wound healing, and dehiscence of the bronchial airway anastomoses. In addition to routine monitoring and treatment of those complications, the early postoperative period is also the time where immunosuppressive therapy is started or continued, nutrition is reinitiated and optimized to patient needs and physical rehabilitation is a priority. Proper postoperative management by an experienced multidisciplinary team is an important requirement for a successful lung transplantation in children.

Keywords

Lung transplantation Intensive care unit Mechanical ventilation Primary graft dysfunction Early transplant period Surgical complications 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Hartmut Grasemann
    • 1
  • Melinda Solomon
    • 1
  • Gary Visner
    • 2
  1. 1.Hospital for Sick Children, University of TorontoTorontoCanada
  2. 2.Division of Pulmonary Medicine, Boston Children’s HospitalBostonUSA

Section editors and affiliations

  • Samuel B Goldfarb
    • 1
  1. 1.The Children's Hospital of PhiladelphiaPhiladelphiaUSA

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