TY - CHAP M1 - Book, Section TI - Overview of Lung Transplantation with Anatomy and Pathophysiology A1 - Camp, Phillip C. A1 - Mentzer, Steven J. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Colson, Yolonda L. A2 - Jaklitsch, Michael T. A2 - Krasna, Mark J. A2 - Mentzer, Steven J. A2 - Williams, Marcia A2 - Adams, Ann Y1 - 2015 N1 - T2 - Adult Chest Surgery, 2e AB - While there are numerous challenges that face the recipient and practitioner, the field of lung transplantation continues to improve and expand with technical, immunological, and donor-related advancements. The utility of thoracic organ transplantation for end-stage lung disease was not meaningfully realized until the development of cyclosporine in the 1980s. In the preceding decades (1963–1983), fewer than 50 lung transplants were performed worldwide, and no recipient survived for more than 10 months. Early lung transplants failed for four principal reasons: nonfunction of the primary graft, dehiscence of the bronchial anastomosis, acute lung rejection, and pneumonia. Developments in surgical technique, perioperative care, and immunosuppressive drugs culminated in the first successful long-term lung transplant, performed in 1983 in a patient with idiopathic pulmonary fibrosis.1 The technical highlights of this operation included the concept of using an omental wrap around the bronchial anastomosis to restore bronchial artery circulation and prevent dehiscence, careful patient selection, and effective long-term immunosuppression with cyclosporine. Shortly thereafter, Patterson et al.2 performed the first successful double-lung transplant in a patient with emphysema (Fig. 108-1). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105844516 ER -