Why is Lung Transplant Surgery Performed?
Damaged lungs can make it challenging for the body to receive the oxygen it requires to function. There exist many diseases as well as conditions which either damage the lungs entirely or hinder their ability to operate effectively. Some of these conditions are:
- Chronic obstructive pulmonary disease (COPD), including emphysema
- Cystic fibrosis
- Scarring of the lungs (pulmonary fibrosis)
- Pulmonary hypertension
- Alpha-1 antitrypsin deficiency
- Severe bronchiectasis
- Lymphangioleiomyomatosis (LAM Lung Disease)
No organ or tissue can survive without oxygen. Oxygen is used throughout the body in chemical reactions to produce energy. The chemical reactions create carbon dioxide as a waste product. Carbon dioxide must then be removed from the body. This is called “gas exchange” (exchanging oxygen for carbon dioxide). The lungs perform both sides of this vital gas exchange for the entire body, both taking in oxygen and expelling carbon dioxide.
Normal lungs are soft and spongy. They are made up of elastic tissue that allows them to stretch. If because of any disease condition the lungs cannot perform their function effectively and the same cannot be treated with medications or medications are no longer working, transplanting lungs is the option.
Some of the diseases in which lung transplant can be a treatment option are:
- Chronic Obstructive Pulmonary Disease (COPD)
- Alpha-1 Antitrypsin Deficiency
- Lymphangioleiomyomatosis (LAM)
- Eosinophilic granuloma
- Interstitial Lung Diseases
- Pulmonary fibrosis
- Airway Diseases
- Cystic Fibrosis (CF)
- Pulmonary Hypertension
- Secondary: Eisenmenger’s Syndrome secondary to a heart defect, or Interstitial lung diseases
Am I Eligible for a Lung Transplant?
Every patient is evaluated individually for his/her suitability for a lung transplant.
A few of the basic requirement for a lung transplant are:
- The transplant assessment shows that you have a lung disease severe enough to require a transplant.
- Your general condition is good enough that you can tolerate the surgery
- You have no other potentially untreatable medical conditions.
- You want to have a transplant and you understand and accept the responsibilities before and after the transplant.
Advantages of Lung Transplant
Many recipients experience:
- Less shortness of breath
- More energy
- Fewer restrictions
- A better quality of life
- A longer life with a transplant
What Happens During a Lung Transplant?
After the lungs of a compatible donor become available, the transplant candidate is called immediately to the transplant centre to prepare for the surgery while the surgical team examines the deceased donor’s lungs to make sure they are fit for transplant. If they are, surgery on the candidate begins immediately.
Surgeons may perform either a single lung transplant or a double lung transplant. There are advantages and disadvantages to each option, and the choice varies with the recipient’s lung disease and other factors. The lung transplant cost also depends on the type of procedure chosen.
A surgeon makes a large incision in the chest which varies by the type of lung transplant:
- In case of single lung transplants, the cut is made on the side of the chest where the lung is transplanted. The duration of this surgery is about 4 to 8 hours. In most of the cases, the lung with the worst condition is removed.
- In case of double lung transplants, the cut is made below the breast and reaches to both sides of the chest. The duration of this operation is about 6 to 12 hours.
Complete unconsciousness is maintained throughout the whole procedure with the help of general anaesthesia. Certain lung transplant candidates are required to go on the cardiopulmonary bypass at the time of the surgery. While on bypass, the blood is pumped and enriched with oxygen with the help of a machine, instead of the heart and lungs.
The duration of the recovery of a lung surgery varies from person to person. Some patients may leave the hospital within a week. However, some are in the hospital for two weeks or longer. The first year after the surgery is the most critical period. At this time, the patient is required to frequently visit the doctor and also get all the chest X-rays and blood tests done timely.
From the operating room the patient will be taken to the Intensive Care Unit where there is specially trained staff to look after you. Recipients remain in the ICU until their lung function is stable and they are able to breath on their own. This takes anywhere from a few days to a week on average, but varies with each recipient, and can take several weeks.
Once the transplanted lungs are working fine the patient can be shifted to the wards and after a few days of observation and rehabilitation, planning for discharge is made.
You and your family will be advised several days in advance of your expected discharge date.
The first-year post transplant is most crucial and during this time the patient is seen very frequently by the transplant team. The patient also needs to have blood tests, Chest X rays and lung functions frequently during this period.
A lung transplant can significantly improve the quality of life of an individual. Most people tend to live at least ten years or more after a lung transplant; this is if they get operated from one of the best hospitals for lungs transplant in India.
A lung transplant can significantly improve the quality of life of an individual. In most diseases for which lung transplant is done it also offers survival benefit ie improves the survival of the individual.