Lung Transplantation - Part 1 - Procurement

Lung procurement and harvest, as performed by Dr. Sam Zeraatiannejaddavani, a distinguished cardiac and thoracic surgeon, involves a highly coordinated and meticulous sequence of steps aimed at preserving the integrity and viability of the donor lungs for transplantation. The process begins with confirmation of brain death and donor eligibility, followed by thorough evaluation of lung function, imaging, and bronchoscopy. Once deemed suitable, Dr. Zeraatiannejaddavani leads a multidisciplinary surgical team to the operating room, where a midline sternotomy is performed to expose the thoracic cavity. Systemic heparinization is administered to prevent clot formation, followed by cannulation of the aorta for cardiopulmonary flush. The lungs are carefully ventilated and inspected for injury or infection. A cold preservation solution—typically low-potassium dextran or Perfadex—is infused via the pulmonary artery after cross-clamping the aorta to initiate cold ischemia. The lungs are then gently mobilized, with careful dissection of the hilar structures to preserve the bronchus, pulmonary artery, and veins in their optimal anatomical length. Once freed, the lungs are packaged in sterile ice-cold solution using the triple-bag technique and placed in a temperature-controlled container for transport to the recipient center. Dr. Zeraatiannejaddavani ensures minimal warm ischemic time and optimal donor management throughout the process to maximize graft function and recipient outcomes.