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The Impact of Anesthetic Management on Perioperative Outcomes in Lung Transplantation

2019; Elsevier BV; Volume: 34; Issue: 6 Linguagem: Inglês

10.1053/j.jvca.2019.08.037

1532-8422

Archer Kilbourne Martin, Suraj Yalamuri, Barbara J. Wilkey, Lavinia Kolarczyk, Ashley Virginia Fritz, Arun L. Jayaraman, Harish Ramakrishna,

Organ and Tissue Transplantation Research

THE PERIOPERATIVE management of lung transplantation patients has advanced significantly over the past 56 years since the initial lung transplant was performed by Hardy in 1963. 1 Sellers D. Cassar-Demajo W. Keshavjee S. et al. The evolution of anesthesia for lung transplantation. J Cardiothorac Vasc Anesth. 2017; 31: 1071-1079 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 2 Hardy J.D. The first lung transplant in man (1963) and the first heart transplant in man (1964). Transplant Proc. 1999; 31: 25-29 Crossref PubMed Scopus (43) Google Scholar This advancement not only is limited to basic and clinical scientific achievements, but also extends to team-based coordination of lung transplantation care. 1 Sellers D. Cassar-Demajo W. Keshavjee S. et al. The evolution of anesthesia for lung transplantation. J Cardiothorac Vasc Anesth. 2017; 31: 1071-1079 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 3 Villalon E. Overcoming challenges: Breathing hope through teamwork and long-distance thoracic transplantation. Prog Transplant. 2016; 26: 260-262 Crossref PubMed Scopus (3) Google Scholar Beginning with the isolated work of Demikhov, to the multidisciplinary Toronto Lung Transplant Group and formation of the International Society for Heart and Lung Transplantation (ISHLT), the evolution of perioperative management has been concomitant with a rise in multidisciplinary teamwork. 4 Toronto Lung Transplant GroupUnilateral lung transplantation for pulmonary fibrosis. N Engl J Med. 1986; 314: 1140-1145 Crossref PubMed Scopus (621) Google Scholar , 5 Christie J.D. Edwards L.B. Aurora P. et al. The Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Lung and Heart-Lung Transplantation Report—2009. J Heart Lung Transplant. 2009; 28: 1031-1049 Abstract Full Text Full Text PDF PubMed Scopus (298) Google Scholar , 6 Konstantinov I.E. At the cutting edge of the impossible: A tribute to Vladimir P. Demikhov. Tex Heart Inst J. 2009; 36: 453-458 PubMed Google Scholar Publications describing the role and impact of anesthesiologists as team members for complex surgeries have been reported for both liver transplantation and cardiac surgery. 7 Hofer I. Spivack J. Yaport M. et al. Association between anesthesiologist experience and mortality after orthotopic liver transplantation. Liver Transpl. 2015; 21: 89-95 Crossref PubMed Scopus (35) Google Scholar , 8 Gerstein N.S. Petersen T.R. Ramakrishna H. Evaluating the cardiac anesthesiologist's role in surgical outcomes—A reappraisal based on recent evidence. J Cardiothorac Vasc Anesth. 2017; 31: 283-290 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar A recent survey of 176 lung transplantation centers noted both evidence of the impact of perioperative management on outcomes as well as wide variation in practice patterns worldwide. 9 Tomasi R. Betz D. Schlager S. et al. Intraoperative anesthetic management of lung transplantation: Center-specific practices and geographic and centers size differences. J Cardiothorac Vasc Anesth. 2018; 32: 62-69 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar , 10 Gelzinis T.A. Anesthetic management of lung transplantation: Center specific practices and geographical and centers size differences. J Cardiothorac Vasc Anesth. 2018; 32: 70-72 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Building upon the concept of teamwork that has been significant throughout the history of lung transplantation, evaluating the role and impact of an anesthesiologist as a member of the lung transplantation team is emerging and vital. In this paper, the authors briefly examine non-anesthetic variables affecting outcomes, and proceed to focus on the impact of perioperative anesthetic management on lung transplantation outcomes.