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Lung transplantation for mechanically ventilated patients
P A Flume1, T M Egan, J H Westerman
1Department of Medicine, University of North Carolina School of Medicine, Chapel Hill.
Summary
Mechanical ventilation is not a contraindication for lung transplantation. Most patients requiring mechanical ventilation before lung transplant can be successfully extubated shortly after surgery, with outcomes comparable to other recipients.
Area of Science:
- Cardiology
- Pulmonology
- Transplantation Medicine
Background:
- Lung transplantation success has increased, broadening selection criteria.
- Mechanical ventilation is a controversial contraindication due to infection and respiratory muscle concerns.
Observation:
- Seven double lung transplants were performed on six mechanically ventilated patients.
- Preoperative mechanical ventilation duration varied (7-115 days).
- Most patients were extubated within 19 days post-transplant.
Findings:
- Prolonged postoperative ventilation was only needed in one patient with acute lung injury.
- No early bacterial infections were observed.
- Outcomes and hospital stay were similar to non-ventilated lung transplant recipients.
Implications:
- Mechanical ventilation may not be a significant contraindication for lung transplantation.
- Broader patient selection for lung transplant is feasible.
- Further research into managing ventilated patients undergoing lung transplant is warranted.