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Lung Transplant

A lung transplant is a surgical procedure to replace irreversibly diseased lungs with healthy lungs. This surgery is advocated for those patients who are dependent on oxygen and those who have a high possibility of death due to the underlying lung disease within the next 6-12 months. 

These diseases include COPD, pulmonary fibrosis, bronchiectasis and cystic fibrosis. This now includes post-COVID lung fibrosis and those on VV ECMO. 

Know More About Surgery

A lung transplant is considered the last option for the treatment of respiratory failure and may be required in the end stages of the following conditions : 

  • Chronic obstructive pulmonary disease (COPD): is a chronic lung condition that results in obstruction of the airflow. This results in difficulty in breathing,  productive cough and wheezing. Commonly seen amongst chronic smokers.  
  • Cystic Fibrosis: It is an inherited life-threatening disorder (seen mainly in Caucasian race) that results in the affection of cells producing mucus, sweat, and digestive juices that cause death overtime. 
  • Pulmonary hypertension: It is an abnormal increase in the blood pressure in the arteries of the lungs usually caused by an untreated hole in the heart. Results in right-sided heart failure. 
  • Pulmonary fibrosis: When lung interstitial tissues get scarred and thickened.It has the worst prognosis among all lung diseases. 
  • Routine blood investigations
  • V/Q Scan 
  • Pulmonary function test 
  • Chest HRCT  
  • ECG and 2 D Echocardiogram 
  • Coronary Angiogram 
  • CTPA and CPET  
  • Women need to get a Pap smear, gynecology evaluation, and a mammogram. 

 

The steps of procedure for the Lung Transpant Surgery are- 

  • A plastic tag and bracelet with name and number is assigned to the patient. 
  • An IV (intravenous line) is inserted into the arm of the patient before the surgery begins. 
  • Then the venous catheters are placed in the neck and groin of the patient. Also, BP monitoring lines are inserted in the radial and femoral arteries. A Urinary catheter is also placed and a nasogastric tube is placed in the stomach. 
  • General anesthesia is given to the patient and a breathing tube is put into the throat. The patient is attached to the ventilator.
  • An incision is made by the surgeon in the chest. Usually, for a bilateral sequential transplant, the incision is going to be made horizontally across the chest below the breasts.
  • The patient is placed on cardiopulmonary bypass using a heart-lung machine.  
  • The diseased lungs are removed and replaced with the donor’s lungs.
  • 4-6 drainage tubes are put in the patient’s chest. 

 

The risks of lung transplant surgery include- 

  • Bleeding (heavy)
  • Infection 
  • Thrombosis  
  • Dehiscence of the airway suture line 
  • Pulmonary edema  
  • Lung rejection 
  • Osteoporosis and bone fractures  
  • High cholesterol levels

 

  • The patient is kept in the ICU for 1-2 weeks after the surgery. The vitals are monitored, the catheter is placed to empty the bladder and a flexible bronchoscopy is done. The ventilator is removed after 1-3 days. 
  • The nasogastric tube is taken out when bowels resume normal function.  
  • Blood samples are taken many times in a day, this is done to monitor the health of the new lungs, kidneys and liver. The patient is given opioids for pain control.  
  • The immunosuppressive medicines are gradually increased to monitor the bone marrow, kidney, and liver function. 
  • ICCU Nurses, ID doctors, and physiotherapists will monitor the patients closely.   

 

Lung Transplant from one of the best multi-speciality hospital: Manipal Hospital Goa, Dona Paula, Panaji

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