ABSTRACT
The intent of this chapter is to summarize the current practice of pulmonary transplanta tion. It is not meant to be exhaustive in scope, because excellent detailed and extensive reviews are available. Instead, the focus is on selected features that are particularly relevant to pulmonary medicine specialists who manage patients with end-stage lung and pulmo nary vascular disease and who refer them for transplantation. Advances in survival and related outcomes have been sufficient to ensure that lung transplantation will be widely practiced in the future. Consequently, pulmonary medicine specialists and pulmonary care providers will be taking a greater role in the postoperative management of the patients they refer for this procedure. There still is much room for improvement. The major factors limiting the widespread application and success of this technique are chronic rejection and donor-organ shortage. Solutions to the problem of chronic rejection are largely the responsibility of transplant physicians, surgeons, immunologists, and pharmacologists. Dealing with the shortage of donor organs is the responsibility of everyone interested in this technique. It would be an oversight to end this chapter without an appeal to the reader to consider ways to increase organ donation at his or her institution.
