A lung transplant is a surgery that replaces a sick or damaged lung by a donor’s healthy lung.
According to data provided by the Organ Procurement and Transplantation Network, the United States has performed more than 36,100 lung transplants since 1988. The majority of these operations involved patients between the ages of 18 and 64.
Lung graft survival has increased in recent years. According to the National Heart, Lung, and Blood Institute (NHLBI), The one-year survival rate for single-lung transplants is around 80%. The survival rate at 5 years is greater than 50%. These numbers were way down 20 years ago.
Survival rates are different depending on the institution. Trying to figure out where to get your surgery, there is a need to ask questions on the survival rates of this institution.
Why you have a lung transplant.
A lung transplant is considered the latest option for treating lung failure. Other treatments and life-style changes will almost always be attempted first.
Diseases that can damage your lungs sufficiently to require transplantation include:
- pulmonary hypertension
- chronic obstructive pulmonary disease (COPD)
- cystic fibrosis
- pulmonary fibrosis
Lung transplant risks
A lung transplant is an important operation. There are a number of risks involved. Before surgery, your doctor should discuss with you if the risks associated with the operation outweigh the benefits. You might also want to talk about what you can do to reduce the risk.
The most important risk for a lung transplant is organ rejection. This occurs when your immune system recognizes the donor’s lung as foreign agent and attacks it as if it were a disease. Severe rejection may result in failure of a given lung.
Other serious complications can be caused by medications used to prevent rejection. These medications are known as “immunosuppressant.” They operate by lowering your immune response, reducing your body’s chances of attacking the new “foreign” lung.
Immunosuppressants increase your risk of infection, as your immune system is reduced.
Other risks associated with lung transplant surgery and the medications you should take following the transplant are:
- kidney damage
- stomach problems
- bleeding and clots in the bloodstream.
- cancer and malignant tumours caused by immunosuppressive agents.
- lowering of densities of your bones (osteoporosis)
You should follow your doctor’s instructions before and after your procedure. It may help you to reduce your risk. The instructions will include healthy lifestyle choices, such as a healthy diet and tobacco and quite smoking. You may also want to avoid missing doses of medication.
How to get ready for the lung transplant.
The emotional check-up on waiting for a donor lung can be difficult.
After receiving the necessary tests and meeting the eligibility criteria, You will remain on a waitlist for a donor lung. How long you wait on the list depends on the following conditions:
- a matching lung is available.
- blood type
- geographical distance from the receiver to the donor.
- the seriousness of your situation.
- the size of the donor lung
- your overall health
Several lab and imaging tests will be performed on you. You can follow emotional and financial advice as well. Your physician must ensure that you are fully prepared for the further effects of the procedure.
Your physician will provide you with complete instructions for the best preparation for your surgery.
If you are waiting for a donor lung, it is best to finish all your preparations beforehand. The notice of availability of an organ may arrive at any time.
Also, verify that all your contact information is updated at the hospital. They must be capable of contacting you when a lung donor is available.
Once you are notified that a lung is available, you will be asked to attend the transplant centre immediately.
How lung transplant is performed
By the time you and your donor get to the hospital, you’ll be ready for the operation. That involves turning into a hospital gown, getting an IV, and going through general anesthesia. It will lead to induced unconsciousness. You will wake up in the recovery room once your new lung is set.
Your surgical team will place a tube in your trachea so you can breathe properly. Another tube can be inserted through the nose. It will drain everything from your stomach. You can use a catheter to drain your bladder.
We can also set you up on a heart-lung machine. This system pumps your blood and adds oxygen to it, for you during the operation.
Your surgeon is going to make a large incision in your chest. If you make that incision, your damaged lung will be removed. After that, a new healthy lung will be connected to your primary airways and blood vessels.
Once the new lung is fully functional, the incision is closed. You will be transferred to a recovering intensive care unit (ICU).
According to the National Hearts, Lung, and Blood Institute (NHLBI), A typical one-lung transplant may take 4 to 8 hours. A transfer of two lungs may take as long as 12 hours.
After a lung transplant
You can try to stay in the intensive care unit for a few days following the procedure. Your vitals will require close monitoring. You may be connected to a power ventilator to help you breathe. The tubes will also connect to your chest to remove any build-up of fluid.
Your entire stay in the hospital could last 4 weeks, but it could be shorter. How long you stay will depend on how you recover from the illness.
Over the next 3 months, you will be meeting regularly with your lung transplant doctor team. They should check for signs of infection, rejection or other problems. You’ll have to live close to the transplant facility.
Before you leave the hospital, you will be instructed on how to treat your surgical injury. You will also receive instructions about the restrictions to follow and drugs.
Your drugs will likely contain one or more types of immunosuppressants, such as:
- Antiproliferative agents (mycophenolate mofetil)
- steroids (prednisone)
- mTor inhibitors (sirolimus)
- calcineurins (cyclosporine ,tacrolimus)
Immunosuppressants are required after the transplant. They help ensure that your body does not attack your new lung. You are likely to take these drugs for the rest of your life.
They put you at risk for infection and further complications. Be sure to check with your doctor about any potential side effects.
It is also possible to receive:
- antifungal medication
- antiviral medication
- anti-ulcer medication
Mayo Clinic says the first year after transplantation is the most critical period. It is at this point that the main problems, infection and release, are the most common. These risks can be reduce by following the instructions of your lung transplant Doctor team and reporting any complications as a matter of urgency.