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From Minimally Invasive to Robotic: Heralding the Future of Lung Transplantation

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Lung transplantation at Cedars-Sinai—a multidisciplinary collaboration between the Smidt Heart Institute and the Comprehensive Transplant Center—is characterized by innovations that are changing the landscape of cardiothoracic surgery and care. We are the only U.S. center offering minimally invasive and robotic-assisted lung transplant to adults with end-stage lung disease and, in 2022, we performed more lung transplants than most programs nationally.

Over the past two years, we have transitioned from offering traditional lung transplantation to minimally invasive lung transplantation to, now, robotic-assisted capabilities. This long-awaited achievement is the start of a new era of cardiothoracic care. Prior to pioneering the world’s first robotically assisted lung transplant, surgeons in the Smidt Heart Institute also developed new, minimally invasive techniques that speed healing and shorten hospital stays.

These outstanding outcomes in a complex case mix could not have been achieved without deliberate innovation in surgical techniques and effective desensitization protocols for immunologically sensitized patients.

180 thoracic organ transplants performed in FY2022

Among the most successful ECMO bridge-to-lung transplants for COVID-19


The COVID-19 pandemic compelled us to use ECMO as a bridge to recovery or transplant for patients with severe lung disease. This experience allowed us to successfully transplant many patients who would previously have been ineligible.

The New England Journal of Medicine published our analysis of lung transplantation in COVID lung disease, which showed excellent short-term outcomes (including 95.6% survival at three months) nationally. This was the first research demonstrating the potential of lung transplantation as an effective treatment of acute respiratory distress syndrome and pulmonary fibrosis caused by COVID-19.


A 57-year-old man with pulmonary fibrosis became the first Southern Californian—and possibly the first in the U.S.—to receive a minimally invasive double lung transplant. Forgoing a sternotomy incision, the minimally invasive approach involved an incision between the ribs and did not require the assistance of a heart-lung machine. The patient was discharged from the hospital after just nine days.

Learn More


Lung transplantation for COVID-19-related respiratory failure in the United States. New England Journal of Medicine; PMC8809503

Extracorporeal life support as a bridge to lung transplantation: Where are we now? Journal of Heart and Lung Transplantation; PMID: 36089445