Lung Transplant

Lung transplant is a surgical procedure replace a damaged or diseased lung with a healthy lung from a donor. It enables the patient to breathe easily and grants many more years of life. One or both the lungs may be replaced in lung transplant procedure, depending on the medical condition of the patient.

INDICATIONS
Lung transplant is recommended when the lung is failing because of any of the below mentioned disease:

  • Pulmonary Hypertension : It means increased pressure in pulmonary arteries which are responsible for transporting blood from heart to the lungs.
  • Cystic Fibrosis : This is an inherited disease that commonly occurs in children wherein sticky, thick mucus starts to form in the lungs which causes repeated and grave lung infections.
  • Chronic Obstructive Pulmonary Disease (COPD) : This is the most prevalent reason of lung transplant in adults. COPD is a disease that gets worse with time and causes great difficulty in breathing.
  • AAT Deficiency (Alpha-1 Antitrypsin Deficiency) : It is a condition that increases the risk of lung disease, particularly because of smoking.
  • Idiopathic Pulmonary Fibrosis : This is yet another condition where the tissues of the lungs become stiff, thick or scarred over time.

PRE-PROCEDURE
The surgeon may take a few tests before the surgery to assess whether you are a right candidate for the operation or not. Test include

  • Blood tests to check for infections
  • Colonoscopy, pap smear, etc. to look for symptoms of early cancer
  • Cardiac catheterization, echocardiogram, etc. to assess your heart condition

You will be asked to refrain from smoking and drinking alcohol and do not put on weight. Follow your exercise regime which you learnt during pulmonary rehabilitation.

DURING PROCEDURE
Lung transplant is a complex procedure that lasts 4 to 8 hours, and is performed under general anesthesia.
A tube will be inserted through the mouth and connected to the windpipe. This allows you to breathe.

  • The surgeon will put a central venous tube into a vein after making a minor incision in your chest. This tube will help to supply medicines and fluid to your body.
  • Another tube will also be inserted in the nose and connected to stomach to empty it. The catheter will keep your bladder content free.
  • Following that, the surgeon will make a cut in your chest to assess the main airway and replace the deceased lung with the donor’s lung.
  • In case, double lung transplant is required, then a heart-lung bypass machine will be connected to you.

POST PROCEDURE
After the procedure, the patient will be monitored in ICU for 3 to 5 days. A ventilator will be used to help the patient breathe effectively. The tube in chest, inserted during the procedure, will help in draining fluids from lungs and heart. The patient will be allowed to take clear fluids after the condition stabilizes, followed by soft diet and normal diet. The patient can go home in 10 to 15 days after the surgery. For next 3 months, frequent consultations along with blood tests, chest X Ray, ECG will be recommended. Smoking and alcohol consumption will be strictly disallowed. Immunosuppressants and blood thinning medications will have to be taken for the rest of the life.

RISK AND COMPLICATIONS
Liver translant is a complex surgery, and has significant risks and complications. Major risks include

  • Rejection of new lung by the body
  • Infection
  • Immunosuppressants and blood thinning medications may have the following side effects
  • High BP and cholestrol
  • Diarrhea
  • Diabetes
  • Kidney damage
  • In rare cases, cancer

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