ABSTRACT
I. Introduction The first human lung transplant was performed in 1963; however, it was not until the 1980s when improvements in surgical technique and immunosuppression regimens turned lung transplantation into the gold standard treatment for a variety of end-stage lung diseases. The number of lung transplants performed since then has been steadily increasing with over 2000 transplants performed at approximately 150 centers as reported in 2008 to The Registry of the International Society for Heart and Lung Transplantation (ISHLT) (1). Survival rates have also gradually improved over the past three decades, and there has been increased interest in recent years regarding the anesthetic management of patients undergoing lung transplant and how it contributes to patient outcomes (2-6). Anesthesiologists taking part in these procedures need to have specific skills with respect to lung isolation (including both technical concerns in achieving lung isolation and physiological concerns with oxygenation during one-lung ventilation), the interpretation and use of invasive monitoring including transesophageal echocardiography (TEE), and the management of respiratory and myocardial impairments. This chapter will provide an overview of these perioperative anesthetic management considerations.
