Lung Transplantation as a treatment strategy for Pulmonary Emphysema

Abstract

The role of lung transplantation is to provide survival and quality of life benefits to patients with advanced lung disease. In this chapter, focusing on chronic obstructive pulmonary disease (COPD), we provide a comprehensive discussion of key aspects involved in the assessment of recipient suitability for transplantation. We discuss key issues such as timing of referral, donor evaluation, and organ allocation. We provide a detailed evaluation of the technical aspects of transplant surgery, evaluating the relative merits of both single and bilateral lung transplantation. In addition, we highlight how the transplant field is addressing donor shortfall, with expansion of acceptable donor criteria and the use of ex vivo lung perfusion to improve donor evaluation. Finally, we examine post-operative morbidity and mortality, discussing both early and late surgical complications and the adverse effects of long-term immunosuppression.