Session to offer practical framework for ICU care in lung transplant

As lung transplantation procedures in the United States reach record levels, better surgical techniques, improved antirejection medications, and the proactive management of posttransplant infections and chronic rejection are allowing more patients to live longer. However, many patients who have undergone lung transplant experience serious complications, leading to the lowest long-term survival rates among all patients of solid organ transplant.

When these patients present with complications outside of the transplant center, it is imperative that intensivists have the knowledge to help care for them, said Bronwyn L. Small, MD, FCCP, Assistant Professor of Medicine at University Hospitals in Cleveland, Ohio.

“There are thousands of hospitals throughout the United States with intensive care units, but only a relatively small number of active lung transplant centers,” she said. “When lung transplant recipients become critically ill, they may initially present at a community ICU or an ICU that does not have staff experienced caring for this patient population.”

Dr. Small will chair the CHEST 2026 session ICU Care for the Lung Transplant Recipient at 2:45 pm MST on Tuesday, October 20, at the Phoenix Convention Center, West Building, Room 106C. Presenters will give clinicians a practical framework for care when a transplant specialist is not immediately available, filling an important educational gap for clinicians practicing outside of transplant centers as well as those who work in transplant centers but who may not routinely manage patients who have undergone lung transplant.

“You don’t need to be a transplant expert to benefit from this session,” Dr. Small said.

During the session, Dr. Small will discuss advanced approaches to posttransplant respiratory failure. Deborah Levine, MD, MS, FCCP, a pulmonologist and lung transplantation specialist at Stanford Medicine, will present data on managing immunosuppression and immunoprophylaxis in a critically ill patient who has undergone lung transplant. Sofya Tokman, MD, a transplant pulmonologist at the Norton Thoracic Institute Transplant Clinic in Phoenix, will present case studies on navigating infectious risks across the transplant journey. And Sadia Shah, MD, MBA, FCCP, a lung transplant pulmonologist and critical care specialist at Mayo Clinic, Florida, will discuss navigating extrapulmonary organ failure in the ICU in a patient who has undergone lung transplant.

“We want this session to be a two-way conversation between the panel members and the attendees,” Dr. Small said. “We will explore what ICU providers are seeing and the areas of care they are the least comfortable delivering; and how transplant centers can better support clinicians in recognizing when a patient’s care can be managed locally or when that care requires specialized attention at a transplant center. This session is extremely valuable for anyone who may have to care for a lung transplant recipient in the ICU.”