ISHLT consensus document on lung transplantation in patients with connective tissue disease: Part II: Cardiac, surgical, perioperative, operative, and post-operative challenges and management statements

Christian A Bermudez; Maria M Crespo; Oksana A Shlobin; Edward Cantu; Jeremy A Mazurek; Deborah Levine; Jacob Gutsche; Manreet Kanwar; Göran Dellgren; Errol L Bush; Gustavo A Heresi; Marcello Cypel; Rachel Hadler; Nicholas Kolatis; Veronica Franco; Luke Benvenuto; Joshua Mooney; Matthew Pipeling; Christopher King; Hannah Mannem; Sanjeev Raman; Christiane Knoop; Aaron Douglas; Olaf Mercier

doi:10.1016/j.healun.2021.07.016

ISHLT consensus document on lung transplantation in patients with connective tissue disease: Part II: Cardiac, surgical, perioperative, operative, and post-operative challenges and management statements

J Heart Lung Transplant. 2021 Nov;40(11):1267-1278. doi: 10.1016/j.healun.2021.07.016. Epub 2021 Jul 29.

Authors

Christian A Bermudez¹, Maria M Crespo², Oksana A Shlobin³, Edward Cantu⁴, Jeremy A Mazurek⁵, Deborah Levine⁶, Jacob Gutsche⁷, Manreet Kanwar⁸, Göran Dellgren⁹, Errol L Bush¹⁰, Gustavo A Heresi¹¹, Marcello Cypel¹², Rachel Hadler¹³, Nicholas Kolatis¹⁴, Veronica Franco¹⁵, Luke Benvenuto¹⁶, Joshua Mooney¹⁷, Matthew Pipeling¹⁸, Christopher King³, Hannah Mannem¹⁹, Sanjeev Raman²⁰, Christiane Knoop²¹, Aaron Douglas²², Olaf Mercier²³

Affiliations

¹ Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Christian.bermudez@pennmedicine.upenn.edu.
² Division of Pulmonary, Allergy, and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
³ Department of Pulmonary and Critical Care Medicine, Inova Fairfax Hospital, Falls Church, Virginia.
⁴ Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
⁵ Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
⁶ Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center San Antonio, Texas.
⁷ Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
⁸ Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania.
⁹ Department of Cardiothoracic Surgery and Transplant Institute, Sahlgrenska University Hospital, Göteborg, Sweden.
¹⁰ Division of Thoracic Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
¹¹ Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
¹² Division of Thoracic Surgery, Toronto General Hospital UHN, Toronto, Ontario, Canada.
¹³ Division of Critical Care, University of Iowa Carver College of Medicine, Iowa City, Iowa.
¹⁴ Division of Pulmonary and Critical Care Medicine, University of California, San Francisco Medical Center, San Francisco, California.
¹⁵ Department of Cardiology, The Ohio State university Wexner Medical Center, Columbus, Ohio.
¹⁶ Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Medical center, New York, New York.
¹⁷ Division of Pulmonary and Critical Care Medicine, Stanford Health Care, Palo Alto, California.
¹⁸ Division of Pulmonary and Critical Care Medicine, Duke University, Durham, North Carolina.
¹⁹ Division of Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, Virginia.
²⁰ Division of Pulmonary Medicine, University of Utah, Salt Lake City, Utah.
²¹ Erasme University Hospital, Brussels, Belgium.
²² Division of Anesthesiology and Critical Care, Cleveland Clinic, Cleveland, Ohio.
²³ Department of Thoracic Surgery, Université Paris-Saclay, Marie Lannelongue Hospital, Le Plessis Robinson, France.

PMID: 34404570
DOI: 10.1016/j.healun.2021.07.016

Abstract

Patients with connective tissue disease (CTD) present unique surgical, perioperative, operative, and postoperative challenges related to the often underlying severe pulmonary hypertension and right ventricular dysfunction. The International Society for Heart and Lung Transplantation-supported consensus document on lung transplantation in patients with CTD standardization addresses the surgical challenges and relevant cardiac involvement in the perioperative, operative, and postoperative management in patients with CTD.

Keywords: ECMO; connective tissue diseases; critical care; lung transplantation surgery; pulmonary hypertension.

Publication types

Practice Guideline

MeSH terms

Connective Tissue Diseases / surgery*
Consensus
Disease Management*
Humans
Lung Transplantation / standards*
Perioperative Care / standards*