Lung transplantation is the surgery performed to replace the diseased lung or lungs with a new and healthy lung donated by a donor. The donor is usually on the life support after the brain dead and under the age of 65. The tissue of the donor must be matching close to the type of the tissue of the patient, to ensure the new lung is not rejected. Lungs can also be donated by the living donors, where two or more donors donate each lobe or segment of the lung, so that the entire lung is formed.
Need for the Lung Transplant Surgery
Lung transplant is recommended by the transplant team, only after the all other treatments are failed for the lung diseases. It is recommended only for under the age of 65, who have been suffering from severe lung diseases.
The lung diseases that may lead to the lung transplant are,
- Cystic fibrosis
- Lung arteries damaged caused from heart defect right from the birth
- Chronic Obstructive Pulmonary Disease or COPD
- Swollen and scarred lung tissue conditions, like interstitial lung disease
- High blood pressure experienced by the lungs arteries or pulmonary hypertension
- Bronchiectasis or destruction of the lung and large airways
However, lung transplant is not done for the following patients.
- Badly nourished
- Too sick
- Smoke abused
- Alcohol or drug abused
- Active hepatitis B
- Active hepatitis C
- Active HIV
- Cancer before 2 years
- Lung disease that may affect the transplanted lung
- Severe disease associated with other organs
Before the Procedure
Before deciding for the lung transplant, the transplant team needs these tests to be done.
- Check for infections through skin and blood tests
- Blood typing
- Tests to lung evaluation
- Tests for early cancer
- Tests for heart evaluation through cardiac catheterization, EKG or echo cardiogram
- Tissue typing to ensure the new lung is not rejected
- The patient is given general anesthesia so that the patient feels no pains and gets asleep.
- A small cut is made over the chest. A heart lung machine is employed during the surgery to function the work of the heart, while the heart is stopped its function, during the surgery.
- For lung transplant,
- When a single lung transplant is done, a small cut is made aside the chest. The transplant procedure takes around 4 to 8 hours of time. Usually, the lung that has worst function will be removed.
- When a double lung transplant is done, the surgical cut is made at lower part or below of the breast, so that either sides of the chest is reached. This surgery needs 6 to 12 hours of time. Then the tubes are sent to enable the flow of the oxygenated blood through the heart lung bypass machine and make free movement of the blood throughout the body.
- After the surgical cut is made, one or two of the lungs are removed from the body. When double transplantation is done, first transplant is completed and then the second one is started.
- The airway and main blood vessels of the lung that is transplanted will be sewn to the airway and blood vessels. The donor’s lobe or lungs will be sutured or stitched in its place. Blood, air and fluid are drained out through chest tubes out from the chest and it is continued until the lungs are re-expanded to full extent.
In case the heart is also diseased, both the lung and heart transplants are done during the same transplant surgery.
After the Procedure
Stay is expected to be 7 to 21 days after the surgery in the hospital. Recovery period to get back to regular and normal activities is 6 months. Regular checkups, x-rays and blood tests are to be followed for years after the surgery.
Risks associated with the lung transplant are,
- Blood clot
- Bone thinning
- Risk of infections
- Risk of cancer in the future
- Rejection of the transplanted lung
- Damage to the other organs
Cost of Lung Transplant Surgery in India
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