- When it's necessary
- When transplantation is not recommended
- How the transplant is done
- What happens during surgery
- How is the recovery of the transplant
Lung transplantation is a type of surgical treatment in which a diseased lung is replaced by a healthy lung, usually from a dead donor. Although this technique can improve the quality of life and even cure some serious problems like cystic fibrosis or sarcoidosis, it can also cause several complications and, therefore, it is only used when other forms of treatment do not work.
Since the transplanted lung contains foreign tissue, it is generally necessary to take immunosuppressive drugs for life. These remedies decrease the chances of the body's defense cells trying to fight foreign lung tissue, avoiding transplant rejection.
When it's necessary
Lung transplantation is usually indicated in more serious situations, when the lung is very affected and, therefore, is unable to supply the necessary amount of oxygen. Some of the diseases that most often need a transplant include:
- Cystic fibrosis; Sarcoidosis; Pulmonary fibrosis; Pulmonary hypertension; Lymphangioleiomyomatosis; Severe bronchiectasis; Severe COPD.
In addition to lung transplantation, many people also have associated heart problems, and in these cases, it may be necessary to have a heart transplant together with the lung or shortly thereafter, to ensure symptom improvement.
Most of the time, these diseases can be treated with simpler and less invasive treatments, such as pills or breathing apparatus, but when these techniques no longer produce the desired effect, transplantation may be an option indicated by the doctor.
When transplantation is not recommended
Although the transplant can be done in almost all people with worsening of these diseases, it is contraindicated in some cases especially if there is an active infection, history of cancer or severe kidney disease. In addition, if the person is not willing to make the lifestyle changes necessary to fight the disease, transplantation may also be contraindicated.
How the transplant is done
The transplantation process begins long before surgery, with a medical evaluation to identify if there is any factor that prevents the transplantation and to evaluate the risk of rejection of the new lung. After this evaluation, and if selected, it is necessary to be on a waiting list for a compatible donor at a transplant center, such as InCor, for example.
This wait can take from a few weeks to several months according to some personal characteristics, such as blood type, organ size and severity of the disease, for example. When a donor is found, the hospital contacts the person who needs the donation to go to the hospital in a few hours and have the surgery. Thus, it is advisable to always have a suitcase of clothes ready to use in the hospital.
At the hospital, it is necessary to make a new evaluation to ensure that the surgery will be a success and then transplant surgery is started.
What happens during surgery
Lung transplant surgery is performed under general anesthesia and can last up to X hours. During this time, the surgeon removes the diseased lung, making a cut to separate the blood vessels and airway from the lung, after which the new lung is placed in place and the vessels, as well as the airway, are connected to the new organ again..
Since it is a very extensive surgery, in some cases, it may be necessary to connect the person to a machine that replaces the lungs and the heart, but after the surgery, the heart and lungs will work again without assistance.
How is the recovery of the transplant
Recovery from lung transplantation usually takes 1 to 3 weeks, depending on each person's body. Right after the surgery, it is necessary to stay in the ICU, as it is necessary to use a mechanical ventilator to help the new lung to breathe correctly. However, as the days go by, the machine becomes less necessary and the internment can move to another wing of the hospital, so there is no need to continue in the ICU.
During the entire hospitalization, the drugs will be administered directly into the vein, to reduce pain, the chances of rejection and also decrease the risk of developing an infection, but after discharge, these drugs can be taken in the form of pills, until the recovery process is finished. Only immunosuppressive drugs should be maintained for life.
After discharge, it is necessary to make several appointments with the pulmonologist to ensure that recovery is going smoothly, especially during the first 3 months. In these consultations, it may be necessary to do several tests, such as blood tests, X-rays or even electrocardiogram.
