PREDICTORS, FREQUENCY, AND INDICATIONS FOR CARDIOPULMONARY BYPASS DURING LUNG TRANSPLANTATION IN ADULTS

The records for 162 lung transplantations performed in 158 patients we re reviewed with regard to the predictors for, frequency of, and indic ations for using cardiopulmonary bypass during the procedure. There we re a total of 8 en bloc double-lung transplantations, 83 single-lung t ransplantations, and 71 bilateral single-lung transplantations. Bypass was used electively for all double en bloc and three of the bilateral sequential lung transplantation procedures and for 26 unilateral lung replacement procedures in patients with pulmonary hypertension. Of th e remaining patients, 1 single-lung transplant recipient required bypa ss for correction of a surgical mishap and 18 bilateral single-lung re cipients required bypass during replacement of the second lung. No pre operative predictors for the need of bypass could be identified. Among the bilateral sequential lung recipients, the use of bypass did not s eem to adversely affect outcome, as expressed in terms of the time unt il extubation, the time spent in the intensive care unit, and the time required to reach a room air oxygen tension greater than 60 mm Hg.