A Lung transplant is a surgical removing of a dysfunctional and diseased lung from the patient’s body and replaces it with a healthy lung from a donor.

Who Need a Lung Transplant?

Most people with severe and end-stage lung disease are considered for a lung transplant. The procedure is considered when someone seems likely to die without the surgery, and no other options are available. A person whose lung disease is so severe that they can no longer enjoy life can also be considered for a lung transplant. However, due to certain reasons people with age between 60 to 65 years are not considered for a lung transplant.

People with these lung diseases need to go for lung transplant:

Chronic obstructive pulmonary disease (chronic bronchitis and emphysema)
Cystic fibrosis
Idiopathic pulmonary fibrosis
Idiopathic pulmonary arterial hypertension
Lung transplant reasons may vary for all people with the above mentioned conditions. For example, in idiopathic pulmonary fibrosis, scar tissue replaces healthy lung and in emphysema, lung tissue is destroyed by smoking.

Lung Transplant Procedure

Preparing for a Lung Transplant

The lung transplant evaluation process is usually complicated and long. Firstly, a doctor needs to refer a patient to a regional transplant center. At the transplant center, doctors, social workers, psychologists, and other staff meet with the person to gather information about him. These meetings may take place on several visits occurring over many weeks and months.

Besides the patient’s lung condition, the team also considers the person’s financial situation, family and social support, medical conditions or any other psychological conditions.

Many tests are performed during a lung transplant evaluation, which are:

Cardiac stress test
Pulmonary function tests
Bone mineral density test
Coronary artery catheterization
Chest X-ray
CT scan of the chest
Blood tests for kidney and liver function, and a complete blood count (CBC) and blood type
Tests for antibodies present in the blood
Doctors usually won’t recommend a lung transplant for patients with these conditions:

Significant heart, kidney or liver disease
Alcohol or drug abuse
Ongoing infections
Anyone who continues to smoke can’t be accepted for a lung transplant
Going on the Lung Transplant List

After tests and interviews have been completed and the patient is considered as a good candidate for a lung transplant, he/she will be listed on the national and regional organ recipient lists.

A person’s place on the list is determined by his/her Lung Allocation Score. This is a complicated calculation that tries to predict how long a patient can live without a lung transplant and how long he/she would be expected to live if they receive a lung transplant?

People with higher Lung Allocation Score are considered first when donors’ lungs become available.

During a Lung Transplant

When a compatible donor’s lungs become available, the patient will be called urgently to the transplant center to prepare for the surgery. Surgical team members travel to examine the deceased donor’s lungs to make sure they are suitable for transplant. If they find it suitable, surgery on the recipient begins immediately, when the lungs are in transit to the center.

The surgeon may perform either a single lung transplant or a double lung transplant. Each option has some advantages disadvantages, and the choice depends on the patient’s lung disease and other factors.

The surgeon will make an incision in the chest. The incision varies by the type of lung transplant:

An incision on one side of the chest (for a single lung transplant)
An incision on either side of the chest or across the entire width of the front of the chest (for a double lung transplant)
This surgery is performed under general anesthesia.

Some patients receiving a lung transplant need to go on cardiopulmonary bypass during the surgery. During this bypass, the blood is pumped and enriched with oxygen by a machine, rather than by the heart and lungs.

After a Lung Transplant

The full recovery time after a lung transplant varies widely between people. Some people are fine to leave the hospital within a week, or some may need to be in the hospital for two weeks or longer.

The receiver needs to follow these points for the timely recovery:

Frequent follow-ups with the doctor
Follow a new lifelong medication plan
Regular physical therapy and rehabilitation exercises
Regular blood tests, chest X-rays, lung function tests, and procedures like bronchoscopy
Recovery

The patient is advised to do regular exercises in order to build up their strength.
After the surgery, for the initial six weeks receiver should avoid pulling, pushing, or lifting anything heavy.
Four to six weeks after the transplant, the patient will be able to drive.
Immunosuppressant

After a lung transplant, the patient needs to take immunosuppressant for the rest of his life. This is because there is a risk that the body can identify the new lung as a foreign organ, and the patients’ immune system can attack it. This is known as rejection syndrome.

Prognosis of lung transplant

Lung transplant is a major surgery that is being performed for people suffering from life-threatening lung disease. After complete recovery from lung transplantation, most of the people do not have any restriction in physical activities. Up to people surviving for five years or more, half of them work at least part-time. Age at the time of transplant is the most important factor for the survival of the transplant.