People who have severe and end-stage lung disease are candidates for this surgical procedure. It is also considered for those who have conditions that would be fatal if the transplant is not done. The most common lung diseases that require this surgery include chronic obstructive pulmonary disease such as emphysema and chronic bronchitis, idiopathic pulmonary fibrosis, cystic fibrosis, and idiopathic pulmonary arterial hypertension.
People who are over the age of 60 are usually discouraged from undergoing a lung transplant due to the associated risks and complications. So are people who have heart, liver or kidney disease, alcohol addiction, smoking habit, drug abuse, infections, and cancer.
Preparing for a Lung Transplant
Before a lung transplant is scheduled, a patient first needs to undergo a long and complicated evaluation process. During this stage, doctors, psychologists, and social workers meet with the patient to talk with him/her and gather information. The evaluation procedure can take about many weeks to a few months. The team doesn't only consider the lung condition of the patient but also other factors such as family and social support, financial status, psychological condition, and other medical condition.
Several tests are performed during this process. These include 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 function and liver function, complete blood count (CBC), blood type and antibodies present in the blood for the purpose of matching against potential donors for the lungs.
When compatible lungs have been found, the patient will be called urgently to the hospital or transplant center to get ready for the surgery. The surgical team will examine the lungs of the deceased donor to find out if these are suitable for transplant. Once this is determined, the surgery is started immediately while the lungs are still in transit.
First, the surgeon will cut an incision in the chest. This can be done on either one side if the transplant is only for a single lung or across the entire chest or both sides if the transplant is for both lungs. The patient will be under general anesthesia throughout the procedure. Some patients need to go on cardiopulmonary bypass during the surgery. This means that the blood is pumped with oxygen from a machine instead of the heart and lungs.
After the Surgery
Recovery time varies from one person to another. Some can leave the hospital only after a week. But others may stay for a few weeks to a month. Activities that will help ensure long-term success for the surgery are regular physical therapy, rehabilitation exercises, medication plan, regular visits to the doctor, regular tests of lung function, and so on.