What is a lung transplant
A lung transplant is a surgical procedure that replaces a diseased or damaged lung with a healthy lung of a donor.
According to data from the Organ Procurement and Transplantation Network, there have been more than 36,100 lung transplants completed in the United States since 1988. The majority of those surgeries were in patients of age 18 to 64 years.
The survival rate for lung transplant patients has increased in recent years. According to the National Heart, Lung, and Blood Institute (NHLBI), the one-year survival rate of single-lung transplants is approximately 80 percent. The five-year survival rate is more than 50 percent. Those numbers were much lower 20 years ago.
Survival rates differ by facility. When researching where to have your surgery, it’s necessary to ask about the survival rates of that facility.
Why a lung transplant is done
A lung transplant is regarded as the last option for the treatment of lung failure. Other treatments and lifestyle changes will almost always be tried first.
Conditions that may damage your lungs enough to need a transplant include:
- chronic obstructive pulmonary disease (COPD)
- cystic fibrosis
- pulmonary fibrosis
- pulmonary hypertension
The risks of a lung transplant
A lung transplant is major surgery. It has several risks. Before the surgery, your doctor should discuss with you whether the risks related to the procedure outweigh the benefits. You should also talk about what you can do to lower your risks.
The main risk of a lung transplant is organ rejection. This happens when your immune system recognizes donor’s lung as is as a foreign substance and attacks it as if it were a disease. Severe rejection could cause failure of the donated lung.
Other severe complications can arise from the drugs used to prevent rejection. These drugs are called “immunosuppressants.” They work by lowering your immune response, reducing the chances of your body to attack the new “foreign” lung.
Immunosuppressants increases your risk of infections, since your immunity is lowered.
Other risks of lung transplant surgery and the medicines you must take after the transplant include:
- bleeding and blood clots
- cancer and malignancies due to immunosuppressants
- kidney damage
- stomach problems
- lowering of densities of your bones (osteoporosis)
It’s necessary to follow your doctor’s instructions before and after your surgery. This can help lower your risks. Instructions will include including healthy lifestyle choices, such as eating a healthy diet and quitting smoking. You should also avoid missing any doses of medications.
How to prepare for a lung transplant
The emotional toll of waiting for a donor lung can be hard.
Once you’ve undergone the necessary tests and fulfilled qualifying criteria, you’ll be kept on a waiting list for a donor lung. Your waiting time on the list depends on the following conditions:
- availability of a matching lung
- blood type
- geographic distance between recipient and donor
- the severity of your condition
- the size of the donor lung
- your overall health
You will undergo several laboratory and imaging tests. You may also undergo emotional and financial counseling. Your doctor needs to ensure that you’re totally prepared for the later effects of the procedure.
Your doctor will give you entire instructions for the best preparation for your surgery.
If you’re waiting on a donor lung, it’s better to complete all your preparations in advance. The notice that an organ is available could come at any time.
Also, confirm thay all of your contact informations are up-to-dated at the hospital. They need to be able to contact you when a donor lung is available.
When you’re informed that a donor lung is available, you’ll be instructed to report to the transplant facility right away.
How a lung transplant is performed
When you and your donor lung come at the hospital, you’ll be prepared for surgery. This involves changing into a hospital gown, receiving an IV, and going through general anesthesia. This will put you into an induced unconsciousness. You’ll awaken in a recovery room after your new lung is in place.
Your surgical team will insert a tube into your windpipe for the proper breathing. Another tube may be inserted into your nose. It will drain your stomach contents. A catheter will be inserted for emptying of your bladder.
You may also be put on a heart-lung machine. This device pumps your blood and adds oxygen to it, for you during surgery.
Your surgeon will make a big incision in your chest. Through this incision, your damaged lung will be removed. Then new healthy lung will be connected to your main airway and blood vessels.
When the new lung is working correctly, the incision will be closed. You’ll be moved to an intensive care unit (ICU) for the recovery.
According to the National Hearts, Lung, and Blood Institute (NHLBI), an usual single-lung transplant can take between 4 and 8 hours. A double-lung transfer can take up to 12 hours.
Following up after a lung transplant
You can look for to remain in the ICU for a few days after the procedure. Your vital signs will require to be strictly monitored. You’ll possibly be hooked up to a mechanical ventilator to help you breathe. Tubes will also be connected to your chest to drain any fluid buildup.
Your total stay at the hospital could last for weeks, but it may be shorter. Your time of stay will depend on how well you recover.
Over the next three months, you’ll have regular appointments with your lung transplant team. They’ll check for any signs of infection, rejection, or other issues. You’ll be needed to live near to the transplant center.
Before you get discharged from the hospital, you’ll be given instructions on how to take care of your surgical wound. You’ll also be instructed about any restrictions to follow and be given medication.
Most probably, your medications will include one or more types of immunosuppressant, some examples are:
- calcineurins (cyclosporine ,tacrolimus)
- Antiproliferative agents (mycophenolate mofetil)
- steroids (prednisone)
- mTor inhibitors (sirolimus)
Immunosuppressants are necessary after your transplant. They help prevent your body from attacking your new lung. You’ll probably take these medications throughout your life.
Though, they leave you open to infection and other complications. Make sure to consult your doctor about all the possible side effects.
You may also be given:
- antiviral medication
- antifungal medication
- anti-ulcer medication
The Mayo Clinic reports that the first year after the transplant is the most critical period. This is when the major problems, infection and rejection, are most common. You can lower these risks by following your lung transplant team’s instructions and urgently reporting any complications.