Lung Transplant: What you need to know about it

Have your lungs become so severely damaged that they can no longer be controlled by medication or other treatments? Your doctor may have mentioned a "lung transplant." It's normal to feel nervous and apprehensive when you hear about such a major surgery. But don't worry. Let's get to the bottom of it. What is a lung transplant? What does it involve? Today, we'll talk about it in simple terms.

Simply put, what is a lung transplant?

A lung transplant is a surgical procedure in which one or both of your diseased or damaged lungs are removed and replaced with a healthy lung or lungs from a donor. Usually, these donated lungs come from a deceased person.

This surgery is only performed on someone with a serious lung disease that cannot be cured with any other medicine or treatment. That is, doctors recommend this surgery as a last resort.

What are the main types of lung transplants?

There are three main types of lung transplants. Let's take a look at what they are.

Who is suitable for this surgery?

Since this is a very serious surgery, not everyone can do it. Doctors consider many factors when choosing a person for this. Generally, to be eligible for this surgery, you must meet the following criteria:

• You must have a serious medical condition that is causing your lungs to not work properly.
• Your condition should be cured with medication or other treatments.
• If you don't have this surgery, the doctors must have decided that you have less than a year or three to live.
• You cannot have lung cancer.
• You must be someone who does not use tobacco products (cigarettes, beedis, etc.).
• You must be physically and mentally able to take immunosuppressive drugs that you will need to take for the rest of your life after surgery.

Why is a lung transplant necessary? What types of medical conditions can it treat?

A lung transplant is recommended for severe lung diseases that are not treatable with any other treatment. Here are some of the conditions that can cause this.

What happens before the surgery? (Pre-transplant Screening)

Before a decision is made as to whether you are a candidate for a lung transplant, you will undergo a very thorough series of tests . This is called `pre-transplant screening.` This is the first step. A specially trained transplant coordinator will gather all of your medical information.

What do these tests look for?

There are many of these tests. Each one is to see if your body can withstand such a major surgery and if you can survive the surgery.

After all these tests, the transplant medical team will come together, analyze all of your records, and make the final decision on whether or not this surgery is suitable for you.

If you are determined to be eligible, your name will be placed on the national lung transplant waiting list . You will then have to wait for a matching lung to become available.

What should you do when you are on the waiting list?

This time is very important. You need to be in the best possible health for the surgery. Your medical team will create a special plan for you.

• Lifestyle changes: You should stop drinking alcohol completely. You should maintain a healthy weight. If you are obese, you should lose weight.
• Medications: Take all medications your doctor prescribes on time. If another doctor gives you a new medication, you should inform the transplant coordinator about it. You should also tell them about any vitamins or herbal remedies you are taking.
• Exercise: A physical therapist will develop a series of exercises that are right for you. You should also work with a respiratory therapist to do breathing exercises to keep your lungs healthy.
• Regular checkups: The doctor will come to see you every two to three months.
• Preparation:A matching lung may become available at any time. So make a transportation plan to get to the hospital. It is a good idea to have a bag of clothes and essentials ready.

What happens during the surgery?

After you are taken to the operating room, the anesthesiologist will give you a sedative so you won't feel any pain. Your heart rate and blood pressure will be monitored constantly.

You will then be connected to a machine called a mechanical ventilator . This is what breathes for you during the surgery. Sometimes, a machine called `ECMO (extracorporeal membrane oxygenation)` may also be used. This temporarily stops the blood from flowing to your heart and lungs, and then a machine cleans the blood and sends it back to your body.

The surgeon makes an incision in your chest and carefully removes the diseased lung or both lungs. Then, a new, healthy lung is transplanted into its place, reconnecting all the blood vessels and airways.

Once everything is connected properly, they check to see if blood and air are flowing to the new lung. Finally, the incision is stitched and the wound is covered.

What happens after the surgery?

After the surgery, you will be transferred to the intensive care unit (ICU). Doctors and nurses will take good care of you until you regain consciousness and your condition stabilizes. Initially, you will be kept on a ventilator to help you breathe.

Once your condition improves, you will be transferred to a normal ward. This is where the most important part begins. You will be given immunosuppressive medications to keep your body from rejecting the new lung. Your body will be closely monitored to see how it responds to these medications.

As you gradually recover, physical therapists and respiratory therapists will start you on exercises to build your strength. You will usually be allowed to go home after 12-14 days, or longer if needed.

What are the risks and complications? (Risks and Complications)

As with any major surgery, there are risks involved. It is important to be aware of these.

• Risks of surgery: Things like problems with anesthesia, excessive bleeding, blood clots, and infections.
• Lung Transplant Rejection: This is the biggest challenge. Our body's immune system is very good at recognizing foreign substances. Therefore, it may see the newly transplanted lung as a "foreign object" and start attacking it. This is called `rejection`.
• Acute Rejection:This can happen within the first year after surgery, but it can be largely controlled with medication.
• Chronic Rejection: This can occur after several years. This condition is difficult to treat.
• Infection: Immunosuppressive medications, which are given to prevent the body from rejecting the new lung, reduce the activity of the immune system. This makes you more likely to develop various infections (bacterial, viral, fungal).

Symptoms of the body rejecting the lung

You should be very careful about these symptoms. If you have any of them, talk to your doctor immediately.

How long does it take to recover? (Recovery Time)

This is a long journey. It won't heal overnight.

• First 3 months: You will need to come to the hospital regularly. You will need to undergo blood tests, X-rays, and physical therapy treatments.
• Weeks 6-8: You can start light exercise and drive.
• 3-6 months: The risk of the body rejecting the lung decreases. Lung function stabilizes.
• 4-6 months: Most people are able to return to work or school.