Advances in lung transplantation.

Success in lung transplantation (LT) has been attributed to proper patient and donor selection, better preservation and surgical techniques, and experience in postoperative management. In 1995, we refined our perioperative management by implementing newer perioperative strategies with critical pathways and have reduced use of cardio-pulmonary bypass (CPB), thereby improving survival after LT. We compared survival, use of CPB, intubation, intensive care unit (ICU) stay, and hospital times between PRE (prior to 1995) and POST cohorts to analyze our changes in LT. The 1-and 3-year survival rates were 57% and 29% for PRE, and 86% and 62% for POST, p < 0.01. The intubation time and ICU and hospital length of stay were significantly reduced in the POST cohort. Also, the need for CPB was reduced by about 40% in the POST group.