Lung Transplant

Definition

This is a surgery to remove severely diseased and damaged lungs. They are replaced with healthy lungs from a deceased donor. One or both lungs may be transplanted. In some cases, a heart transplant is done at the same time. In that case, the procedure is called a heart-lung transplant .

Reasons for Procedure

A lung transplant is done to treat irreversible, life-threatening lung disease, such as:
Normal vs. Emphysemic Lung
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Possible Complications

If you are planning to have a lung transplant, your doctor will review a list of possible complications, which may include:
  • Infection
  • Bleeding
  • Rejection of the donor lung (your body's immune system attacks the new lungs)
  • Conditions related to taking immunosuppressant drugs
    • Infection
    • Cancer
    • Diabetes
    • Kidney damage
    • Osteoporosis
  • Anesthesia-related problems
  • Death

What to Expect

Prior to Procedure

Before you have a lung transplant, you will go through an intensive evaluation. This is done to determine if you are a good candidate for this surgery. During the evaluation, which often requires a hospital stay, you will have some or all of the following tests:
If you are a good candidate for a transplant, you will be put on a waiting list. There is a shortage of donors. You may need to wait a long time. You will need to carry a cell phone with you at all times. This will allow the transplant team to reach you if a donor lung becomes available. Donors are matched carefully for size, tissue type, and other factors. In some cases, a healthy family member can donate a lung if you only need a single transplant.
Leading up to your procedure:
  • Arrange for a ride to the hospital.
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • Your doctor may ask you to stop taking some medications up to one week before the procedure.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure

For a single lung transplant, the doctor will make an incision on your side. It will be about six inches below your underarm. For a double lung transplant, the doctor will make an incision across the lower chest.
You will be put on a ventilator and a heart-lung machine. This machine will take over the functions of the heart and lungs during surgery. Next, the doctor will remove a small section of rib. This will allow access to your lung. The old lung will be cut away from the main blood vessel and bronchus (large airway). The new lung will then be inserted. The doctor will attach the blood vessels and bronchus to the new lung.

Immediately After Procedure

You will stay in the intensive care unit (ICU) for 2-3 days. The doctors and nurses pulse, breathing, and vital functions.

How Long Will It Take?

  • 4-8 hours for a single lung transplant
  • 6-12 hours for a double lung transplant

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

This surgery is done in a hospital setting. The usual length of stay is 7-10 days. Your doctor may choose to keep you longer if you shows signs of rejecting the new lungs or have other problems.

Post-procedure Care

Arrange for help at home until you can manage on your own. There will be some adjustments that you will have to make because of the transplant. These include:
  • Taking immunosuppressive drugs to prevent your body from rejecting the new lung
  • Lung biopsies at regular intervals to check for lung rejection
  • Blood tests
  • X-rays and EKGs
  • Measuring and tracking your temperature, weight, and blood pressure
  • Lifestyle changes, such as:
    • Avoiding exposure to tobacco smoke and other toxic elements
    • Exercising regularly to help maintain lung capacity
    • Limiting your intake of salt, foods high in fat and cholesterol, sweets, and alcohol
It will take about 6 months to recover from a lung transplant.

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
  • Signs of rejection including fever, chills, achiness like the flu, shortness of breath, decreased ability to exercise
  • Signs of infection including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Persistent nausea and/or vomiting
  • Pain that you can't control with the medications you were given
  • Coughing up blood
  • Waking up at night due to being short of breath
  • Increase in phlegm production
  • Pain, burningSudden headache or feeling faint
  • Changes in blood pressure or weight
  • , urgency, frequency of urination, or persistent bleeding in the urine
Call for emergency medical services right away if any of the following occurs:
  • Fast breathing or trouble breathing
  • Cough, shortness of breath, or chest pain
  • Chest pain that is new or worse
  • Blue or gray skin color
If you think you have an emergency, call for medical help right away.

RESOURCES

American Lung Association http://www.lung.org

United Network for Organ Sharing http://www.transplantliving.org

CANADIAN RESOURCES

Canadian Lung Association http://www.lung.ca

Health Canada http://www.hc-sc.gc.ca

References

Explore lung transplant. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/lungtxp. Updated. May 1, 2011. Accessed August 15, 2014.

Lung transplant. Duke Medicine website. Available at: http://www.dukemedicine.org/treatments/transplant-program/lung-transplant. Accessed August 15, 2014.

Lung transplant. Mayo Clinic.com website. Available at: http://www.mayoclinic.org/tests-procedures/lung-transplant/basics/definition/prc-20014091. Updated April 26, 2014. Accessed August 15, 2014.

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