Lung Transplant

Lung Transplant

Lung transplantation is an effective treatment for patients with end-stage lung disease — a condition where the lungs are so diseased that they can no longer perform their normal function to obtain sufficient oxygen for the body.

Who needs a lung transplantation?

Patients with end-stage lung disease are likely candidates for lung transplants. Common causes of end-stage lung disease which require lung transplantation include:

• Chronic Obstructive Pulmonary Disease (COPD)
• Total hip Replacement
• Idiopathic Pulmonary Fibrosis (IPF)
• Bronchiectasis
• Pulmonary Hypertension (Primary and Secondary)

Evaluation of the patient's condition is currently done in the hospital where his underlying lung condition and prospects of a successful transplant are thoroughly reviewed. During this evaluation period, the patient will meet and speak with various members of the transplant team, including the pulmonologist, surgeon, and clinical coordinator.

The evaluation work-up will include a series of blood tests and the condition of the heart, lung, liver and kidney systems. Potential transplant recipients are required to be substance-free at least a year before being listed for the transplant. Harmful habits such as smoking and alcohol or mind-altering drug dependency must be avoided.

During the procedure

Lung transplantation involves removing the diseased lung or lungs from the recipient and replacing either one (single lung transplant) or both (bilateral lung transplant) with healthy ones from a recently deceased donor. Lung transplantation represents the best hope for patients with end-stage lung disease as it can offer patients better quality of life after the transplant.

Long-term care

The quality of life for patients improves dramatically after a lung transplant and they are able to lead more active lifestyles, which includes returning to work. Patients, however, must take several medications for life after a lung transplant. The most important drugs are those that keep the body from rejecting the transplant. A patient's survival depends on many factors, including age, general health and response to the transplant. The survival rate after lung transplantation worldwide is reported to be 92 per cent, 79 per cent and 63 per cent for the first month, first year and third year respectively. Early mortality (<90 days) is most often due to infection and late mortality (>90 days) is most often related to rejection. Survival rates are higher for patients undergoing lung transplantation for COPD compared to those whose indications were IPF or pulmonary hypertension.

How are the donors found?

Donors are individuals who are brain-dead, meaning that the brain shows no signs of life while the person's body is being kept alive by artificial means. Most donors are those who have died due to road accidents, strokes or severe head injuries. Depending on the availability of a lung for transplant, patients may have to wait for months to years. 

What are the criteria for lung transplant?

When the transplant team decides that a patient is suitable for transplantation, the patient's name will be placed on the waiting list. Donor lungs are matched with recipients according to the following criteria :

• Size (height and weight)
• Chest measurements (chest circumference and chest x-ray measurements)
• Blood type (O, A, B or AB)

The quality of the donor lungs is of utmost priority. Donor lungs are thoroughly evaluated by the lung transplant team. The evaluation includes examination of the donor's chest x-ray, medical history, social history (with particular emphasis on tobacco and substance abuse), amount of oxygen in the blood (arterial blood gases) and bronchoscopy (direct visualisation of the donor airway with an endoscope).

Can a person lead a normal life after lung transplantation?

The quality of life for patients improves dramatically after a lung transplant and they are able to lead more active lifestyles, which includes returning to work. Patients, however, must take several medications for life after a lung transplant. The most important drugs are those that keep the body from rejecting the transplant. A patient's survival depends on many factors, including age, general health and response to the transplant.