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Michael K. Pasque
Charles B. Huddleston
Robert F. Cerza
Joel D. Cooper
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Ann Thorac Surg 1994;57:1248-1251
© 1994 The Society of Thoracic Surgeons

Articles

Predictors, frequency, and indications for cardiopulmonary bypass during lung transplantation in adults

Anastasios N. Triantafillou, MD*, Michael K. Pasque, MD, Charles B. Huddleston, MD, Charles G. Pond, MD, Robert F. Cerza, MD, Robert M. Forstot, MD, Joel D. Cooper, MD, G.Alexander Patterson, MD, Demetrios G. Lappas, MD

Divisions of Cardiothoracic Anesthesiology and Surgery, Washington University School of Medicine, St. Louis, Missouri, USA

Accepted for publication September 1, 1993.

* Address reprint requests to Dr Triantafillou, Department of Anesthesiology, Washington University Medical Center, 660 S Euclid Ave, Box 8054, St. Louis, MO 63110.

The records for 162 lung transplantations performed in 158 patients were reviewed with regard to the predictors for, frequency of, and indications for using cardiopulmonary bypass during the procedure. There were a total of 8 en bloc double-lung transplantations, 83 single-lung transplantations, and 71 bilateral single-lung transplantations. Bypass was used electively for all double en bloc and three of the bilateral sequential lung transplantation procedures and for 26 unilateral lung replacement procedures in patients with pulmonary hypertension. Of the remaining patients, 1 single-lung transplant recipient required bypass for correction of a surgical mishap and 18 bilateral single-lung recipients required bypass during replacement of the second lung. No preoperative predictors for the need of bypass could be identified. Among the bilateral sequential lung recipients, the use of bypass did not seem to adversely affect outcome, as expressed in terms of the time until exhibition, the time spent in the intensive care unit, and the time required to reach a room air oxygen tension greater than 60 mm Hg.




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