[Selection and maintenance of lung donors]

Lung transplantation is a relatively modern procedure that can afford improvement in quality of life to certain terminal patients with irreversible respiratory failure. Selection of the donor and the recipient must be both strict and flexible, as we apply criteria that are constantly being revised and extended. The care afforded the donor must include certain elements: exhaustive monitorization that serves to guide the intravenous replacement of fluids and maintenance of hemodynamic stability; assisted ventilation with PEEP, FiO2 under 0.4 and adequate flow volumes; prevention and treatment of neurogenic pulmonary edema; and prevention of infections through careful airways management involving appropriate antibiotic prophylaxis. The same protocol must be maintained while the organ is being extracted and the organ itself must be properly preserved until implanted. The anesthesiologist is fully involved in optimum management of the lung donor. We consider that such care is essential for achieving more and better quality lung donations.