Background
pulmonary opacities, end-stage lung disease, blood loss, ARDS, hypoxemia, bleeding/coagulopathy, coagulopathy, normovolemia
LUNG, BLOOD LOSS, COMPLICATION, CHRONIC LUNG ALLOGRAFT DYSFUNCTION, SECONDARY, COAGULOPATHY, ARDS
Lung transplantation (LuTx) remains the ultimate treatment for end-stage lung disease refractory to optimized medical therapy. Post-implantation, long-term outcomes are impaired by ongoing medical factors including chronic lung allograft dysfunction (CLAD). CLAD (and its phenotypes) represents a major complication that limits the 5-year survival to approximately 55% [PGD is defined by the presence of diffuse pulmonary opacities on thoracic imaging and various levels of hypoxemia without other identifiable causes developing in the first 72 h after lung allograft reperfusion [A reduction in blood loss during surgery and corresponding decrease in intraoperative transfusion of blood products can be achieved by utilizing intraoperative point of care (POC) targeted bleeding/coagulopathy management strategies such as rotational thromboelastometry (ROTEM), platelet function analyzer (PFA) or multiple electrode platelet aggregometry [Despite the abovementioned reduction in blood product transfusion, ongoing fluid resuscitation is necessary to maintain normovolemia during LuTx surgery. A few studies have described the potential benefits of 5% albumin solution administration for the treatment of patients with ARDS and during cardiac surgery [We present a secondary analysis of our randomized clinical trial evaluating the effect of POC coagulopathy management and intraoperative administration of 5% albumin as primary resuscitative fluid during LuTx surgery on early lung allograft function, incidence of PGD, and 1-year survival.