Lung Transplant: Everything You Need to Know
A lung transplant is a procedure that’s evolved over time, offering more encouraging figures. A person who undergoes this type of surgery will require continuous emotional support and a lot of discipline to change their lifestyle.
A lung transplant is a surgical procedure in which one or both diseased or failing lungs are replaced by healthy ones, provided by a deceased donor. It’s a complex surgery that significantly improves the patient’s quality of life.
The first successful lung transplants were performed in the 1960s by Dr. James D. Hardy and then by Dr. Denton A. Cooley in 1968. The first patient was a two-month-old girl with congestive heart failure and recurrent pneumonia.
Medical professionals resort to this type of procedure when a patient has end-stage lung disease or a serious condition that has proven resistant to traditional treatments. Lung transplant candidates must meet certain requirements to be eligible.
Why is a lung transplant performed?
Typically, medical professionals only resort to a lung transplant when all available treatments to fix the lung failure haven’t worked. Generally speaking, this surgery is indicated for people under 75 years of age who have a serious lung condition.
Some of the diseases that can lead to a lung transplant are the following:
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Pulmonary hypertension
- Pulmonary fibrosis
Lung transplant candidates must meet certain requirements, as we already mentioned above. To be eligible for the procedure, they must meet them. Here are some of the criteria medical professionals take into account:
- Age. Patients must be 75 or younger. However, patients 55 and older are considered more high-risk.
- Body mass index. It shouldn’t be higher than 35.
- Risk of dying. This procedure is ideal for patients who have a 50% risk of dying in the next two years if they don’t get the transplant.
- High chance of survival after transplant. Based on the patient’s general state of health.
- Commitment. The transplant recipient should be fully committed to never smoke again, not use psychoactive drugs, and to participate in a pulmonary rehabilitation program.
Those who have an active infection can’t get the procedure. It may not be appropriate for patients who’ve had cancer in the last two years or who have a serious health problem in another organ. Likewise, those who are malnourished or who don’t have a support network that guarantees adherence to post-transplant treatment.
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Lung transplant risks
Lung transplant is a complex surgery that has considerable risks. The most important is organ rejection and infection. The former occurs when the patient’s immune system attacks the transplanted lung or lungs.
Anti-rejection medications can prevent this from happening. However, they can cause side effects, such as weight gain, stomach problems, and facial hair growth. These drugs also make a person more prone to developing other diseases, such as diabetes, osteoporosis, kidney failure, and high blood pressure.
Therefore, after this type of transplant, the patient must follow strict hygiene measures and avoid crowds or sick people. Finally, another possible risk is clot formation after the surgery, due to increased blood clotting.
The process of performing a lung transplant begins long before the surgery takes place. After a patient has been evaluated and deemed eligible for the procedure, the hospital puts them on a waiting list until there’s a donor.
While the transplant candidate waits for a donor, they must follow their doctor’s lifestyle instructions. When a lung is available for the procedure, they evaluate compatibility with the patient. If it’s compatible, medical professionals can perform the transplant.
A patient on a waiting list for lung transplantation should be ready to answer the transplant coordinator’s call as soon as it occurs. Patients should have a suitcase ready with their personal belongings and regular medications.
When the patient arrives at the hospital, they’ll undergo a series of tests to verify compatibility. Doctors will also evaluate their general state of health. If they have any doubts, they may cancel the procedure. If everything is okay, the surgery will be performed almost immediately.
Lung transplants are performed under general anesthesia. If a single lung is going to be transplanted, the surgery lasts between four and eight hours. If both lungs are transplanted, it may take between six and twelve hours.
Here are the steps to the procedure:
- Firstly, the medical professional activates an extracorporeal circulation system (heart-lung machine).
- If they’re only going to transplant one lung, they make an incision on the side of the chest.
- If they’re going to transplant both lungs, they make an incision below the chest that spans both sides of the thorax.
- Then, they remove one or both lungs and attach the blood vessels and airways of the new organs to the patient’s body.
- Probes are inserted to drain air, fluid, and blood from the chest. They’ll stay there for several days until the new lungs expand normally.
- Once the lungs are working, the medical professionals remove the heart-lung machine.
The patient must stay in the hospital for a period of between seven and 21 days. They’re likely to spend several days in the intensive care unit (ICU) after the surgery. However, each medical center has its own protocols.
The first 24 to 48 hours are crucial. During this period, doctors carefully monitor the patient and evaluate the lungs, heart, kidneys, and state of mind. Likewise, they verify that there’s no bleeding or hemorrhages.
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Recovery after a lung transplant
The recovery period is about six months. During the first three, the patient’s doctor closely monitors and evaluates the functioning of the lungs. This way, they can prevent any complications.
In this first stage, the patient will have to visit the hospital frequently to get tests, including X-rays, biopsies, laboratory tests, and electrocardiograms. Doctors also monitor the patient’s reaction to medications.
After this phase, the patient must make changes in their life, which include taking immunosuppressants and regularly attending therapies and checkups. The first year after a lung transplant is the most critical. After the first year, all the risks begin to decrease.
In most cases, the patient will have to visit their doctor weekly for the first three months. Then, they’ll require quarterly checkups for a year. After that, an annual visit for the next five to 10 years.
Long term survival after a lung transplant
According to the available data, the average life span after a lung transplant is 5.8 years. This can vary, depending on the person’s previous illness. Those with cystic fibrosis may survive eight or more years after surgery.
On average, idiopathic interstitial pneumonia patients survive 4.8 years. 32% of those who’ve undergone this procedure live 10 years or more. The highest risk of death is during the first 12 months. Thus, medical controls are reinforced during that time.