UPDATE IN INTENSIVE CARE: TRANSPLANTS Lung transplant: An emerging challenge in the ICU Trasplante pulmonar: un reto emergente en la UCI

Lung transplantation shows good early results (1-year graft survival rate of 82.2%). Moreover, survival over a 5-year period is still high (50.5%). Lung transplantation is associated with substantial risks and severe complications that account for early mortality in the postoperative period (mainly primary graft failure, infection, bleeding and airways complications). However, long-term survival is determined primarily by the development of bronchiolitis obliterans syndrome (BOS), the effects of which may be manifested as progressive respiratory failure or by an increased risk of infection. In 2011, 235 lung transplants were conducted in Spain, being a big challenge in the postoperative period in 7 hospitals. Two physicians of each of these institutions, plus a coordinator discussed current challenges in a meeting in Santiago in October 2011 and launched a research cooperative network (PLUTO network). Some of the expositions will be reported in this series as reviews and original articles. This subgroup of immunosupressed patients is unique given that the transplanted organ is in constant direct contact with the environment and is deprived of its lymphatic drainage and nerve supply, rendering it unique susceptibility to infections. Even more, it has been suggested that over-immunosupression in lung-transplanted patients is real and is detectable in patients with infectious complications. Because the number of lung transplants has been increasing over the years, and has been accompanied by higher survival rates, we may anticipate that the number of lung transplanted patients readmitted to ICU will continue to rise in the forthcoming years. The study of this sub-population is, thereby, of extreme relevance and actuality. This issue of Medicina Intensiva begins