A complete guide to lung transplant

Lung Transplant Process – A Definitive Guide to the Complete Process

A lung transplant is a surgical procedure which involves the replacement of one or both lungs of a person that are unhealthy or damaged. This surgery is prescribed to patients who have incurred a lung condition or injury that has disrupted the proper functioning of their lungs and does not respond to medications. Usually, a lung donation comes from a deceased person.

Types of Lung Transplant

Lung transplants are of three types, as given below: 

• Single lung transplant: In this condition, only one lung that is damaged is removed from the patient's body and replaced with a donated lung.
• Double lung transplant: Double lung transplant deals with the replacement of both lungs in the patient's body whose both lungs have started malfunctioning.
• Heart-lung transplant: In such a case, the heart and both the lungs of a patient are replaced by a pair of donated lungs and heart. 

When is a Lung Transplant done? 

Damaged or unhealthy lungs may make it difficult for a person's body to get the adequate amount of oxygen that their body requires for survival. Besides, there might be other causes that can prevent the lungs from functioning properly, which may require a lung transplant. Here are a few common causes that may require a lung transplant: 

• Cystic fibrosis
• Chronic obstructive pulmonary disease
• Pulmonary hypertension (high BP in lungs)
• Pulmonary fibrosis or lung scarring
• Heart defects or diseases that also affect the lungs
• Other diseases such as histiocytosis, sarcoidosis, lymphangioleiomyomatosis
• Hereditary conditions, etc. 

How a lung transplant is performed?

To get a lung transplant done, the patient first reaches out to the best hospital for a lung transplant and seeks advice for the surgery. After getting a lung donor, the donor and receiver both reach the hospital to get prepared for the surgery. During the surgical procedure, an intravenous line is inserted in the arms or hands of the patient who undergoes a lung transplant. This IV line is used for delivering anesthesia so that the person does not experience any sort of pain during the surgical procedure.

Further, the heart rate and blood pressure are monitored by the doctors, and once everything is normal, the procedure starts. 

Once the anaesthesia works on the body of the patient, the doctor connects a mechanical ventilator to the patient's body to enable breathing. A urinary catheter is also inserted in the patient's body so that it can collect any urine that is discharged during the procedure. Such a procedure may also require an ECMO, which is a mini heart-lung machine that is used to bypass the flow of blood to the heart and lungs. This machine pumps blood from the patient's body and removes carbon dioxide, replacing it with oxygen that helps maintain healthy tissues.

Next, an incision is made at the side of the chest of the patient using a sharp, sterile knife in the case of a single lung transplant. In the case of a double lung transplant, a horizontal incision is made across the chest under the breast tissue. Further, the damaged lung is removed by the healthcare providers and replaced with the donor's lung. After the replacement, the blood vessels and airways are connected using surgical thread and needles so that the transplanted lung receives blood to keep the tissues alive. 

Once the blood starts flowing to the transplanted lung, silicone tubes of small size are placed in the affected areas to drain out blood, air and other fluids from the chest. These tubes also help in expanding the new lungs. Later, all the machines are disconnected from the patient's body, and the incisions are closed and covered with bandages.

Risks of lung transplant

A lung transplant needs major surgery, and thus there are quite a few risks associated with such a surgical procedure. Before undergoing such a necessary, it is imperative for the patient to discuss the types of risks involved in undergoing such a surgery. Also, one should find out whether the risks involved outweigh the benefits and seek further consultation to reduce the potential risks. 

• One of the major risks in a lung transplant procedure is organ rejection which occurs due to the attack of the immune system on the donor's lung. The immune system attacks the donated lung considering it to be a disease which can also lead to donated lung failure. 
• Another risk is the chance of accruing infections due to the effect of immunosuppressants. Immunosuppressants are drugs given to a patient who undergoes a lung transplant surgery to suppress the working of the patient's immune system so that it doesn't attack the donor's lung. But at times, such drugs can cause infections due to the suppression of the immune system. 

Other risks include: 

1. Stomach problems
2. Kidney damage
3. Osteoporosis
4. Malignancy caused due to immunosuppressants.
5. Blood clots
6. Chances of accruing cancer
7. Diabetes
8. Blockage of blood vessels that connects the new lungs
9. Pulmonary oedema
10. Airway blockage, etc. 

Thus, it is essential for the patient to follow the instructions of the doctor pre- and post-surgery to reduce the chances of associated risks. Also, make sure that you do not miss any medication as prescribed by your doctor.