What is Lung Transplant?
A lung transplant is a surgical operation in which a diseased or failing lung is replaced with a healthy lung from a deceased donor. A lung transplant is intended for those who have tried alternative medications or treatments but still haven't seen enough improvement in their condition.
Your body may struggle to get the oxygen it requires if your lungs are unhealthy or damaged. A range of disorders and ailments can harm your lungs and make it difficult for them to function properly.
The following are some of the more common causes:
- Chronic obstructive pulmonary disease (COPD), including emphysema
- Scarring of the lungs (pulmonary fibrosis)
- High blood pressure in the lungs (pulmonary hypertension)
- Cystic fibrosis
Medication or specific breathing devices can often be used to address lung problems. However, if these treatments fail or your lung function becomes life-threatening, your doctor may recommend a single-lung or double-lung transplant.
In addition to a lung transplant, certain people with coronary artery disease may require a surgery to restore blood flow to a blocked or narrowed artery in the heart. People with significant heart and lung diseases may require a combined heart-lung transplant in some situations.
There are 3 main types of lung transplant:
Single lung transplant - A single lung transplant involves removing a single damaged lung from the recipient and replacing it with a lung from a donor; this is commonly used to treat pulmonary fibrosis, but it is not suitable for people with cystic fibrosis because infection will spread from the remaining lung to the donated lung.
Double lung transplant- A double lung transplant, in which both lungs are removed and replaced with two donated lungs, is the most common treatment option for persons with cystic fibrosis or COPD.
Heart-lung transplant– A heart-lung transplant, in which the heart and both lungs are removed and replaced with a donor heart and lungs; this is frequently advised for persons with severe pulmonary hypertension.
Unfortunately, the demand for lung transplants vastly outnumbers the supply of accessible donated lungs.
When is Lung Transplant required?
A lung transplant will be needed when:
- a person has advanced lung disease that isn't responding to other treatments
- a person's life expectancy is estimated to be less than 2 to 3 years without a transplant.
The following are some of the conditions that can be treated with a lung transplant:
- Chronic obstructive pulmonary disease (COPD) - a general term for a number of conditions that damage the lungs, usually as a result of smoking
- Cystic fibrosis - an inherited condition that causes the lungs and digestive system to become clogged up with a thick, sticky mucus
- Pulmonary hypertension - high blood pressure in the blood vessels that carry blood from the heart to the lungs
- Idiopathic pulmonary fibrosis - scarring of the lungs
Because the cancer could return in the donor lungs, a lung transplant would not be suggested for someone with lung cancer. If you smoke, you will not be considered for a lung transplant.
A lung transplant is a serious procedure that carries a number of risks. Before the operation, your doctor should talk to you about whether the risks of the procedure outweigh the benefits. You should also discuss what you can do to mitigate the risks.
Evaluation & Finding the Donor
Evaluation and matching procedure:
A lung transplant evaluation is often lengthy and cumbersome. First and foremost, the physician sends the patient to a local transplant centre where the physicians evaluate the patient. This could happen multiple times over the course of several weeks.
In addition to the patient's lung health, the doctors consider the patient's family support, financial circumstances, psychological composition, and any other medical issues.
Several tests are carried out during a lung transplant evaluation, including:
- Pulmonary function tests
- Cardiac stress test
- Coronary artery catheterization
- Bone mineral density test
- Chest X-ray
- Computed tomography (CT scan) of the chest
- Blood tests for kidney and liver function, and a complete blood count (CBC)
- Blood type and antibodies present within the blood, for matching against potential organ donors
If the patient is judged to be a suitable candidate for lung transplant after the tests and interviews, his or her name is added to the regional and national organ recipient lists.
The Lung Allocation Score determines an individual's position on the list based on a complex computation that attempts to forecast two things:
- How long is it likely that a patient will live without a lung transplant?
- When a patient receives a lung transplant, how long can they expect to live?
When organ donors' lungs become available, people with better scores are given priority.
For foreigners coming to India for a lung transplant, it may take a few weeks to several months before you can find a donor for your lung transplant in India.
How is Lung Transplant done?
The duration of lung transplant surgery depends on the complexity of your case.
- For a single-lung transplant, surgery will take between 6 and 8 hours.
- For a double-lung transplant, surgery will take 8 to 12+ hours.
The surgery is done under general anesthesia. You will have a breathing tube inserted into your throat and connected to a breathing machine (ventilator).
A cut (incision) will be made in your chest by the surgeon. An incision will be made on the side of the chest where the lung will be replaced for a single lung transplant. An incision will be made horizontally across the chest below the breasts for a bilateral sequential transplant.
You may be placed on a cardiopulmonary bypass machine, depending on your lung status and the type of transplant being performed (heart-lung machine). During the procedure, this machine delivers blood and oxygen to your body.
The diseased lung(s) will be removed and the donor lung will be implanted in its place (s). The blood arteries and airways of the new lung will be connected. The lungs will be attached one by one in a bilateral sequential transplant. Stitches or surgical staples will be used to close the incision.
What is the Recovery after Lung Transplant like?
The patient is shifted to an Intensive Care Unit (ICU) after the lung transplant procedure, where he/she will stay for a few days spending on the recovery.
The patient is on a ventilator until he/she is able to breathe on their own. This could take anywhere from a few hours to several days.
The patient will need to take anti-rejection medications for the rest of life in order for the transplanted lung(s) to survive in the body.
The recovery process following a lung transplant is a long and slow one that tries to gradually improve the patient's health and fitness. Resuming normal daily activities could take up to three to four months.
What Results Can I Expect from Lung Transplant ?
People who have undergone a lung transplant in recent years have had a better outlook, and this trend is predicted to continue.
Approximately 9 out of 10 persons survive a lung transplant, with the majority of these surviving for at least a year.
After a lung transplant, about 5 out of 10 persons will live for at least 5 years, with many living for at least 10 years.