LUNG TRANSPLANTATION

Solid-organ transplantation has flourished during the last decade, wit h transplantation of heart and lungs becoming available to patients wi th end-stage cardiac or pulmonary diseases. The first lung transplant was performed in 1963 on a 58-year-old man with bronchogenic carcinoma . He survived for 18 days. During the next two decades, approximately 40 lung transplant procedures were attempted without success. These ea rly attempts at lung transplantation were unsuccessful because of the development of lung rejection anastomotic complications, or infection in the transplant recipients. In the early 1980s, human heart-lung tra nsplantation was successfully performed for the treatment of pulmonary vascular disease. After this procedure, single-lung transplantation f or the treatment of end-stage interstitial lung disease and obstructiv e lung disease was developed. More recently, the technique of double-l und transplantation has come into existence. This article reviews vari ous aspects of lung transplantation, including immunosuppression, lund graft preservation, the various surgical techniques and types of lund transplant procedures available, recipient and donor selection criter ia and postoperative care of the transplant recipient. In addition, in fectious and noninfectious complications seen in this particular patie nt population including acute and chronic rejection, will be discussed .