Lung Transplant: Facts, Cost & Procedure

Lung Transplant: Facts, Cost & Procedure 

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Introduction

A lung transplant is a surgical treatment for people with severe lung disease that has destroyed most of the lungs' function to bring back easier breathing and provide years of life. This procedure involves removal of one or both diseased lungs from a patient and the replacement of the lungs with healthy organs from a donor. Depending on your medical condition, a lung transplant may involve replacing one of your lungs or both of them. In some situations, the lungs may be transplanted along with a donor's heart.

Now, as we already know that lung failure is the main reason for undergoing through Lung Transplant Procedure but have you ever thought of what are the reasons behind lung failure?

Well, these are the following disease which causes lung failure:

• Chronic obstructive pulmonary disease (emphysema and chronic bronchitis): A group of lung diseases that block airflow and make it difficult to breathe.
  Causes due to Smoking, long-term exposure to lung irritants such as industrial dust and chemical fumes, By Birth disease (Preterm Birth), Inherited through genes.
• Cystic fibrosis: An inherited life-threatening disorder that damages the lungs and digestive system.
• Causes due to: Mutation in CFTR genes (these genes are responsible for providing instructions for making a channel that transports negatively charged particles called chloride ions into and out of cells), Inherited through genes.
• Sarcoidosis: The growth of tiny collections of inflammatory cells in different parts of the body including lungs.
• Causes due to: It is triggered by our body's immune system responding to foreign substances, such as chemicals, viruses, or bacteria.
• Advanced Idiopathic Pulmonary Fibrosis: Scaring of Lungs that involves the buildup of scar tissue deep inside the lungs, between the air sacs. This damaged lung tissue becomes stiff and thick, making it difficult for your lungs to work efficiently.
• Causes due to: Smoking, long-term exposure to lung irritants such as industrial dust and chemical fumes.

Types of Lung Transplantation

Single Lung Transplant - This procedure is done for patients with Pulmonary Fibrosis and cannot be suitable for people suffering from Cystic Fibrosis. During this procedure only single damaged lung is replaced with a healthy lung from a donor, there might be a possibility in which infection might spread from the remaining lung to the donated lung.

Double Lung Transplant - Double lung transplant is generally done to treat COPD, recommended for people with severe pulmonary hypertension. In this surgical procedure, both diseased lungs are removed and replaced with the healthy donated lungs. This is suitable for patients suffering from Cystic Fibrosis.

Eligibility

Getting diagnosed with one of the chronic lung diseases is not enough, in order to undergo Kidney Transplant one must meet following eligibility criteria:

• In general terms, the patient must be physiologically 60 years of age or less for bilateral lung transplantation and 65 years of age or less for single lung transplantation. This means that your physical condition must at least meet the typical condition of someone 60 years old or younger, or someone 65 years old or younger. Your chronological age is not a factor.
• He/ She must have a poor prognosis, with an anticipated 18 to 24-month survival.
• One must have no other life-threatening disease.
• One must have demonstrated absolute compliance with medications and medical recommendations, and have good rehabilitation potential.
• He/ She must demonstrate emotional stability and must know the implications of organ transplantation.
• He/ She must have a supportive social support system.

The process of Lungs Transplant:

Donor: In this procedure, organ is obtained from the deceased donor

At the hospital

In India, Govt. policies are very strict related to transplant to avoid any illegal activities related to it. Whenever a case related to transplant comes in a hospital, the case is presented to the legal committee, which evaluates the credibility of the case (i.e. the condition of the patient, condition of the donor, relation of the donor with patient etc).

After arriving at the hospital, you will undergo tests to check if the donor's lung is a good match and whether you are healthy enough to go through the surgery. The donor lung also must be healthy in order to get approval from the transplant team. The transplant can also be cancelled if the chances of success don't appear in the surgery.

Donor: In this procedure, organ is obtained from the deceased donor

The number of people needing lung transplants far exceeds the number of donated lungs available. When a donor organ becomes available, the donor-recipient matching system administered by the United Network for Organ Sharing (UNOS) finds an appropriate match based on specific criteria, including:

• Overall health of the patient
• Blood group
• Size of organ compared with chest cavity
• Condition of the recipient's lung disease
• Distance between donor organ and transplant recipient
• Chance of success of the transplant

During the procedure:

Once the donor's lung passes the criteria set by our team, the organ will be accepted for transplantation. Single lung, double lung or combined heart-lung transplant will be done depending on the disease of the patient. Usually, patients with bronchitis, cystic fibrosis and pulmonary hypertension will benefit from double lung transplantation.

The transplantation will be performed under general anaesthesia so the patient will not feel any pain. The surgery usually takes anywhere between 6 to 12 hours depending on whether it is single or double lung or if any complication occurs.

Doctors will insert a tube through patient's mouth and into the windpipe to help to breathe. The patient will also have a tube in his/her nose straight down to stomach to remove the contents inside. A catheter will keep his/her bladder empty.

After that, the surgeon will make a cut in the chest to remove the diseased lung. The main airway to that lung and the blood vessels between of that lung and heart will then be connected to the donor's lung. For some lung transplants, patients may be connected to a heart-lung machine, which circulates your blood during the operation.

Immediately after the surgery, the patient will be admitted to a dedicated heart and lung transplant unit for recovery.

After the procedure (Recovery Period):

In Hospital:

After surgery patient is shifted to ICU (Intensive Care Unit) to deliver strong medications to control pain and to prevent rejection of your new lung

The patient will be moved out from ICU (Intensive Care Unit) as the use of mechanical ventilator will not be needed as his/her condition improves. The recovery time is generally between 7 to 20 days, depending upon the patient to patient.

After Discharge from Hospital:

After patient gets discharged from the hospital, patient should stay nearby at the hospital or transplant facility for regular follow-ups. These follow ups involves frequent monitoring is done by the doctors to check if the new lungs are functioning properly, if any complication is detected than proper treatment is done to remove that complication.

Living a healthy lifestyle is key to sustaining your new lung. Smoking isn't allowed, and the use of alcohol is strictly limited. Following a nutritious diet also can help you stay healthy.

Exercise is an extremely important part of rehabilitation after your lung transplant and will begin within days of your surgery. Your health care team will work with you to design an exercise program that's right for you.

Risks after the Transplant

Attack from Immune System:

Our immune system defends our body against foreign substances and it will treat the new lung or lungs as foreign substance try to attack and reject it. Drugs called immune suppressant is given to patient along with other medicine to suppress the body's immune system to prevent organ rejection. Generally this drug is continued for 1 to 2 years after transplant but it might be possible that patient has to take these anti-rejection drugs for the rest of your life.

Side effects of Immunosupressants

Following can be the noticeable side effects:

• Weight gain
• Stomach problems
• Acne
• Facial hair

Some anti-rejection medications can also increase your risk of developing new or aggravating existing conditions, such as:

• Diabetes
• Kidney damage
• Osteoporosis
• Cancer
• Hypertension

Risk of infection

Talking about IMMUNOSUPPRESSANT the name itself express the nature of these drugs i.e. to suppress your immune system. As immune system of patient's body will be weaken, thus it makes patient more vulnerable to infections, particularly in new organ (i.e. lungs).

Living a hygienic and healthy lifestyle and by following below mentioned precaution oneself can prevent or resist the risk of infection:

• Wash hands regularly
• Proper cleaning and care of teeth and gums
• Protect skin from scratches and sores
• Avoid infectious areas, crowd or people who are ill
• Take vaccinations

For more information please contact us at

Email: enquiry.fortishospitals@gmail.com

Phone: +91-973-000-1540