It is a surgical procedure in which a patient's diseased lungs are partially or totally replaced by lungs which come from a donor. Donor lungs can be retrieved from a living donor or a deceased donor. A living donor can only donate one lung lobe. With some lung diseases a recipient may only need to receive a single lung. With other lung diseases such as cystic fibrosis it is imperative that a recipient receive two lungs. While lung transplants carry certain associated risks, they can also extend life expectancy and enhance the quality of life for end-stage pulmonary patients.
In most cases, a lung transplant is done only after all other treatments for lung failure unsuccessful. Lung transplants may be recommended for patients under age 65 who have severe lung disease. Some examples of diseases that may require a lung transplant are:
• Cystic fibrosis
• Damage to the arteries of the lung because of a defect in the heart at birth (congenital defect)
• Destruction of the large airways and lung (bronchiectasis)
• Emphysema or chronic obstructive pulmonary disease (COPD)
• Lung conditions in which the lung tissues become swollen and scarred (interstitial lung disease)
• High blood pressure in the arteries of the lungs (pulmonary hypertension)
• Are too sick or badly nourished to go through the procedure
• Continue to smoke or abuse alcohol or other drugs
• Have active hepatitis B, hepatitis C, or HIV
• Have had cancer within the past 2 years
• Have lung disease that will likely affect the new lung
• Have severe disease of other organs
The doctor will do the following tests to determine if you are a good candidate for the operation:
• Blood tests or skin tests to check for infections
• Blood typing
• Tests to evaluate your heart, such as EKG, echocardiogram, or cardiac catheterization
• Tests to evaluate your lungs
• Tests to look for early cancer (Pap smear, mammogram, colonoscopy)
• Tissue typing, to help make sure your body will not reject the donated lung
Lung transplant requires a stay in a hospital. The way the procedure is done may vary. It depends on your condition and your health care provider's methods. In most cases, the procedure will follow this process:
• You will be asked to remove your clothes and given a hospital gown to wear. You will also be asked to remove jewelry or other objects.
• A plastic bracelet with your name and an identification number will be put on your wrist. You may get a second bracelet if you have allergies
• An intravenous (IV) line will be put in your arm or hand.
• Thin, flexible tubes (catheters) will be put on your neck, wrist, under the collarbone (subclavian), or the groin. These are used to monitor your heart and blood pressure, and to take blood samples.
• You will lie down on an operating table.
You should expect to stay in the hospital for 7 - 21 days after a lung transplant. You will likely spend time in the intensive care unit (ICU) right after surgery. Most centers that perform lung transplants have standard ways of treating and managing lung transplant patients. The recovery period is about 6 months. Often, your transplant team will ask you to stay close to the hospital for the first 3 months. You will need to have regular checkups with blood tests and x-rays for many years.