It is a surgical procedure in which a patient's diseased lungs are partially or totally replaced by lungs which come from a donor.
Donor lungs can be retrieved from a living donor or a deceased donor.
A living donor can only donate one lung lobe. With some lung diseases a recipient may only need to receive a single lung.
CONTRAINDICATIONS:
Despite the severity of a patient's respiratory condition, certain pre-existing conditions may make a person a poor candidate for lung transplantation:
Donor lungs can be retrieved from a living donor or a deceased donor.
A living donor can only donate one lung lobe. With some lung diseases a recipient may only need to receive a single lung.
CONTRAINDICATIONS:
Despite the severity of a patient's respiratory condition, certain pre-existing conditions may make a person a poor candidate for lung transplantation:
- Chronic illness (congestive heart failure, kidney disease, liver disease);
- Current infections, including HIV and hepatitis, although more and more often Hepatitis C patients are both being transplanted and are also being used as donors if the recipient is Hepatitis C positive.
- Current or recent cancer.
- Current use of alcohol, tobacco, or illegal drugs.
- Psychiatric conditions.
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TRNSPLANT REQUERIMENTS:
REQUERIMENTS FOR POTENTIAL DONORS:
There are certain requirements for potential lung donors, due to the needs of the potential recipient. In the case of living donors, this is also in consideration of how the surgery will affect the donor:
-Age and health
-Size match; the donated lung or lungs must be large enough to adequately oxygenate the patient, but small enough to fit within the recipient's chest cavity.
-Blood type
TYPES OF LUNG TRANSPLANTS:
LOBE
It´s a surgery in which part of a living or deceased donor's lung is removed and used to replace the recipient's diseased lung.
SINGLE-LUNG
Many patients can be helped by the transplantation of a single healthy lung. The donated lung typically comes from a donor who has been pronounced brain-dead.
DOUBLE-LUNG
This is especially the case for people with cystic fibrosis, due to the bacterial colonization commonly found within such patients' lungs; if only one lung were transplanted, bacteria in the native lung could potentially infect the newly transplanted organ.
HEART LUNG
Some respiratory patients may also have severe cardiac disease which would necessitate a heart transplant. These patients can be treated by a surgery in which both lungs and the heart are replaced by organs from a donor or donors.
"In 3-Way Transplant, Living Patient Donates Heart"
REQUERIMENTS FOR POTENTIAL DONORS:
There are certain requirements for potential lung donors, due to the needs of the potential recipient. In the case of living donors, this is also in consideration of how the surgery will affect the donor:
-Age and health
-Size match; the donated lung or lungs must be large enough to adequately oxygenate the patient, but small enough to fit within the recipient's chest cavity.
-Blood type
TYPES OF LUNG TRANSPLANTS:
LOBE
It´s a surgery in which part of a living or deceased donor's lung is removed and used to replace the recipient's diseased lung.
SINGLE-LUNG
Many patients can be helped by the transplantation of a single healthy lung. The donated lung typically comes from a donor who has been pronounced brain-dead.
DOUBLE-LUNG
This is especially the case for people with cystic fibrosis, due to the bacterial colonization commonly found within such patients' lungs; if only one lung were transplanted, bacteria in the native lung could potentially infect the newly transplanted organ.
HEART LUNG
Some respiratory patients may also have severe cardiac disease which would necessitate a heart transplant. These patients can be treated by a surgery in which both lungs and the heart are replaced by organs from a donor or donors.
"In 3-Way Transplant, Living Patient Donates Heart"
PROCEDURE:
-In single-lung transplants, the lung with the worse pulmonary function is chosen for replacement. If both lungs function equally, then the right lung is usually favored for removal because it avoids having to maneuver around the heart, as would be required for excision of the left lung.
The process starts out after the donor lung has been inspected and the decision to accept the donor lung for the patient has been made. An incision is generally made from under the shoulder blade around the chest, ending near the sternum. An alternate method involves an incision under the breastbone. In the case of a singular lung transplant the lung is collapsed, the blood vessels in the lung tied off, and the lung removed at the bronchial tube. The donor lung is placed, the blood vessels reattached, and the lung reinflated. To make sure the lung is satisfactory and to clear any remaining blood and mucus in the new lung a bronchoscopy will be performed. When the surgeons are satisfied with the performance of the lung the chest incision will be closed.
-A double-lung transplant, also known as a bilateral transplant, can be executed either sequentially, en bloc, or simultaneously. Sequential is more common than en bloc. This is effectively like having two separate single-lung transplants done.
-In single-lung transplants, the lung with the worse pulmonary function is chosen for replacement. If both lungs function equally, then the right lung is usually favored for removal because it avoids having to maneuver around the heart, as would be required for excision of the left lung.
The process starts out after the donor lung has been inspected and the decision to accept the donor lung for the patient has been made. An incision is generally made from under the shoulder blade around the chest, ending near the sternum. An alternate method involves an incision under the breastbone. In the case of a singular lung transplant the lung is collapsed, the blood vessels in the lung tied off, and the lung removed at the bronchial tube. The donor lung is placed, the blood vessels reattached, and the lung reinflated. To make sure the lung is satisfactory and to clear any remaining blood and mucus in the new lung a bronchoscopy will be performed. When the surgeons are satisfied with the performance of the lung the chest incision will be closed.
-A double-lung transplant, also known as a bilateral transplant, can be executed either sequentially, en bloc, or simultaneously. Sequential is more common than en bloc. This is effectively like having two separate single-lung transplants done.
RISKS
Signs of rejection:
Signs of rejection:
- fever
- flu-like symptoms, including chills, dizziness, nausea, general feeling of illness, night sweats
- increased difficulty in breathing
- worsening pulmonary test results
- increased chest pain or tenderness
- increase or decrease in body weight of more than two kilograms in a 24-hour period.
POST-OPERATIVE CARE
Immediately following the surgery, the patient is placed in an intensive care unit for monitoring, normally for a period of a few days. The patient is put on a ventilator to assist breathing. Nutritional needs are generally met via total parenteral nutrition, although in some cases a nasogastric tube is sufficient for feeding.
After this stage, patients are typically required to attend rehabilitation gym for approximately 3 months to regain fitness. Light weights, exercise bike, treadmill, stretches and more are all a part of the rehabilitation programme.
Immediately following the surgery, the patient is placed in an intensive care unit for monitoring, normally for a period of a few days. The patient is put on a ventilator to assist breathing. Nutritional needs are generally met via total parenteral nutrition, although in some cases a nasogastric tube is sufficient for feeding.
After this stage, patients are typically required to attend rehabilitation gym for approximately 3 months to regain fitness. Light weights, exercise bike, treadmill, stretches and more are all a part of the rehabilitation programme.