Contemporary Lung Transplantation de Alessandro Bertani

Contemporary Lung Transplantation: Organ and Tissue Transplantation

Alessandro Bertani

Patrizio Vitulo

Paolo Antonio Grossi

Lung transplantation is a successful therapeutic option for patients with end-stage respiratory failure. Although the clinical outcomes of this procedure have been constantly improving, yet the care of patients undergoing lung transplantation is still a striking challenge for the entire team involved in the process. The complexity of a clinical lung transplant program requires a trained, multi-specialist team and a continuing technical update. Technology provides exciting new opportunities for the improvement of clinical outcomes.

This text provides a comprehensive, practical and up-to-date insight into clinical lung transplantation. It moves along the pre-, intra-, and post-operative phases of transplantation. It explores the most relevant surgical, medical and immunological concepts of this field. The contents focusses not only on the technical, scientific and medical aspects of lung transplantation, but also on the administrative, regulatory and nursing topics of running a lung transplant program.

Rather than presenting purely theoretical chapters, the text sets the focus on clinical dilemmas and practical issues involving all the professionals who actively run a lung transplant program.

The reader will be able to access the book for reference on any topic related to clinical care in lung transplantation. This text is intended as a practical resource for surgeons, physicians and health professionals involved in lung transplantation or in setting up a lung transplant program. All chapters are written by experts in their fields and will include the most up to date scientific and clinical information. The overall intent of this publication is to assist the health care provider in all the daily aspects of lung transplantation and to offer a modern, practical source of suggestions and answers.

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Cuprins

Building a lung transplant program.- The medical challenge of lung transplantation.- Lung transplantation: a job not only for doctors.- Psychological aspects of lung transplantation.- Lung transplantation from a US perspective.- Lung transplantation from an international perspective.- Ethics and legal issues in lung transplantation.- A modern view of transplant immunology and immunosuppression.- Lung transplantation for cystic fibrosis.- Lung transplantation for restrictive lung disease.- Lung transplantation for pulmonary hypertension.- Lung transplantation for COPD and alpha 1 anti-trypsin deficiency.- Lung TX for connective tissue disorders.- Lung transplantation for rare indications.- Pediatric lung transplantation.- Dealing with difficult bugs. The complex perspective of infectious disease.- Managing the lung transplant waiting list.- Excluding patients from transplantation: a clinical dilemma.- “I got a call”: the assessment of lung donors.- Using HCV donors and other high-risk donors.- Choosing the right patient for LTX: tissue typing, cross-matching and size matching.- Procuring and preserving the lungs.- Ex-Vivo Lung Perfusion: promises and reality.- Donation of the lungs after circulatory death.- Artificial bridge to transplantation: why yes, why not, and how.- Anesthesia for lung transplantation.- The choice of medications for a lung transplant recipient: a difficult mix.- Technique and controversies of single lung transplantation.- Technique and controversies of double lung transplantation.- Volume reduction techniques of the graft and results.- Technique and controversies of combined heart-lung transplantation.- Re-transplantation of the lung(s).- Technique and controversies of pediatric lung transplantation.- What pump should I use during surgery?.- Living donor lung transplantation: has the time come?.- Rounding in the Intensive Care Unit after lung transplantation.- Should I go back on ECMO? Management of Primary Graft Dysfunction.- Surgical complications of lung transplantation.- Management of viral infections complicating lung transplantation.- Dealing with bacterial infections after lung transplantation.- Dealing with fungal infections after lung transplantation.- Immunological surveillance after transplantation.- Large airway disease after transplant: one name, many issues.- The complex spectrum of chronic allograft rejection.- Malignancies complicating lung transplantation.- Back to breathing: life after lung transplantation.- Is lung transplantation always an accountable option?.- Building basic and clinical research around transplantation: don’t leave clinical care alone.- Data collection and quality control: the role of scientific societies, OPOs, governmental agencies.- Clinical trials in lung transplantation: what is really needed?.- Long term artificial lung support: will we get there?.