INTENSIVE CARE AND RESUSCITATION: Edited by Paolo Pelosi and Marcelo Gama de AbreuProtective ventilation for lung transplantationLucangelo, Umbertoa; Del Sorbo, Lorenzob; Boffini, Massimoc; Ranieri, V. MarcodAuthor Information aDepartment of Perioperative Medicine, Intensive Care and Emergency, University of Trieste, Cattinara Hospital, Trieste bDepartment of Anesthesia and Critical Care Medicine cDepartment of Cardiac Surgery dDepartment of Anesthesia and Intensive Care Medicine, University of Turin, S. Giovanni Battista Molinette Hospital, Turin, Italy Correspondence to V. Marco Ranieri, Department of Anesthesia and Intensive Care Medicine, University of Turin, S. Giovanni Battista Molinette Hospital, Corso Dogliotti 14, 10126 Turin, Italy. Tel: +39 11 633 4001; fax: +39 11 696 0448; e-mail: [email protected] Current Opinion in Anaesthesiology: April 2012 - Volume 25 - Issue 2 - p 170-174 doi: 10.1097/ACO.0b013e32834fdb54 Buy Metrics Abstract Purpose of review Lung transplantation has been one of the great medical advances as the last option for the treatment of end-stage pulmonary disease. Optimal pulmonary care of potential donors and recipients can definitely increase the number of successful lung retrievals and reduce the incidence of complications. Recent findings The use of a lung-protective ventilatory strategy, associated with recruitment maneuvers, has a profound clinical impact, doubling the number of lungs available for transplant. Postoperatively, it is important to use a lung-protective ventilation strategy, whereas for patients with life-threatening reperfusion injury, extracorporeal membrane oxygenation can ensure a survival rate between 50 and 80%. Pumpless extracorporeal carbon dioxide removal system allows the maintenance of normal gas exchange and can be maintained in the perioperative period. Summary Perioperative ventilatory care of the transplanted patient still represents a challenge for the ICU clinician. The lung-protective strategy and the early application of carbon dioxide removal systems can increase the number of lung donor eligibility. Further studies are needed to increase the viability of other organs and to develop new strategies that reduce the risk of ischemia–reperfusion injury, which still represents the most common complication in the postoperative period. © 2012 Lippincott Williams & Wilkins, Inc.