Lung and heart-lung transplantation in Hong Kong.

OBJECTIVE: To review the donor and recipient selection criteria, surgical techniques, perioperative and post-operative management, and complications of lung/heart-lung transplantation. DATA SOURCES: Medline and non-Medline search of the relevant English literature, local data, and personal experience. STUDY SELECTION: Studies containing supporting evidence were selected. DATA EXTRACTION: Data were extracted and analysed independently by the authors. DATA SYNTHESIS: Lung/heart-lung transplantations are considered only for patients who have progressively disabling and end-stage disease. Numerous investigations of the recipient and rigorous matching between the donor and recipient are required. Factors such as maintaining the donor's haemodynamic stability, graft preservation, effective perioperative immunosuppression, and careful postoperative monitoring are key to a successful transplantation. Follow-up should include the home-monitoring of body weight, temperature, and spirometry, as well as regular chest X-rays, pulmonary function tests, and blood tests. So far, two double and two single lung transplantations, and one heart-lung transplantation have been performed in Hong Kong. CONCLUSION: Lung transplantation is an invaluable treatment modality for patients with end-stage lung disease.