What you need to know about lung transplant

Have you or someone you know ever been told by a doctor about a lung transplant? Or have you heard about it but are unsure of what it is? A lung transplant is a major surgery. It's understandable that you might have many questions, concerns, and concerns about it. So today, let's explain it to you in a simple, understandable way, as if you were talking to a close friend.

Simply put, what is a lung transplant?

A lung transplant is a surgical procedure in which one or both of your diseased, malfunctioning, or damaged lungs are removed and replaced with a healthy lung or lungs from a donor. Most often, the lungs that are donated in this way come from a deceased person.

Doctors usually recommend this type of surgery for someone with a very serious lung disease that cannot be cured by any other medicine or treatment.

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 eligible for a lung transplant?

This is not a surgery that everyone can have. Several factors are considered to determine if you are a good candidate for this surgery.

In general, you are a good candidate for this surgery if you meet the following criteria:

• You have a serious illness or condition that prevents your lungs from working properly.
• Your lung disease has not been cured by any other medicine or treatment.
• Doctors have determined that if you don't have this surgery, your life expectancy is limited to one to three years.
• You don't have lung cancer.
• You do not use tobacco products (such as smoking).
• You can take immunosuppressive drugs.

What types of conditions is this surgery performed for?

A lung transplant may be recommended in many cases, including the following conditions:

• Bronchiectasis
• Chronic obstructive pulmonary disease (COPD)
• Severe lung damage caused by COVID-19
• Cystic fibrosis (CF)
• Interstitial lung disease (ILD)
• Pulmonary hypertension

What happens before the surgery?

Before you have a lung transplant, you will undergo a very thorough and detailed series of tests. This is called pre-transplant screening . This is the first step in determining whether this surgery is the best treatment for you. A specially trained transplant coordinator will gather all of your medical information.

This includes tests like:

• Checking your overall health.
• Family history of disease.
• Details about the medications you are taking, especially blood thinners.
• Recent CT scan and chest X-ray reports.
• Blood tests.
• Tissue typing - This checks to see if your body tissue is compatible with the donor's tissue.
• Pulmonary function tests.
• Heart tests (ECG, Echocardiogram, Cardiac catheterization).
• Bone density test (DEXA scan).

After all these tests, your transplant team will come together, review all these reports, and make a final decision about whether you are a good candidate for this surgery. If they decide you are, your name will be added to the national lung transplant waiting list .

What happens when you are on the waiting list?

You may have to wait months, even years, for a suitable lung to be found. Because while there are many people who need this surgery, there are only a limited number of lungs available for donation. So, there are a few things you can do:

• Lifestyle changes: You should completely stop drinking alcohol. You should maintain a healthy body weight.
• Exercise: An exercise program is provided to keep you in the best possible physical condition.
• Appointments: You should meet with your medical team every two to three months to check your health.
• Preparation: A suitable lung can become available at any time, so it's important to have a transportation plan to get to the hospital. It's also a good idea to have a bag ready with necessary clothing, toiletries, and other items.

What happens during surgery

This is a delicate operation that takes many hours. A single lung transplant can take about 4-8 hours, and a double lung transplant can take about 6-12 hours.

1. First, you will be fully anesthetized . So you will not feel any sensation or pain during the surgery.

2. You will be connected to a breathing machine (mechanical ventilator) . This machine will breathe for you throughout the surgery.

3. You may need to use a special machine called ECMO (extracorporeal membrane oxygenation) to reroute blood to your heart and lungs.

4. The surgeon will make an incision in your chest at an appropriate location and remove the diseased lung or both lungs.

5. Then, the donated healthy lung is placed in place, and the blood vessels and airways are very delicately reconnected.

6. After confirming that blood and air are flowing properly to the new lung, the incision is sewn back together.

What are the risks and complications after surgery?

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

• Risks of surgery: The common risks of any surgery, such as bleeding, blood clots, and infection, are also present here.
• Lung transplant rejection: This is the biggest challenge. Simply put, your body's immune system recognizes the newly transplanted lung as an "enemy" and begins to attack it. To prevent this, you will need to take immunosuppressive drugs for the rest of your life.
• Infection: Due to the aforementioned immunosuppressant medications, your body's ability to fight disease is reduced. Therefore, you are more likely to develop various infections.

What are the symptoms of lung rejection?

You should be very aware of these symptoms. If you have any of them, notify your doctor or transplant team immediately.

Recovery time and life ahead

After surgery, you will be kept in the intensive care unit (ICU) for a few days, then transferred to a regular ward. It may take 2 weeks or more to fully return home from the hospital.

The recovery period is long. You will need to come to the hospital regularly for check-ups and treatment for the first 3-6 months. You will be able to exercise, drive, and return to work after a few months, but all of this will depend on the advice of your medical team.

One of the main benefits of this surgery is an increase in life expectancy and quality of life. Breathing difficulties are gone, and you gain the strength to carry out daily activities and exercise.

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