Lung transplantation is a type of surgical treatment in which a diseased lung is replaced by a healthy one, usually from a dead donor. Although this technique can improve quality of life and even cure some serious problems such as cystic fibrosis or sarcoidosis, it can also cause several complications and is therefore only used when other forms of treatment do not work.
Since the transplanted lung contains tissue foreign to the body, it is usually necessary to take immunosuppressive medicines for life. These drugs lessen the chances that the body's defense cells will try to fight the foreign lung tissue, avoiding a transplant rejection.
When it's necessary
Lung transplantation is usually indicated in more severe situations, when the lung is very affected and, therefore, can not provide the amount of oxygen required. Some of the diseases that most often require 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 those cases, it may be necessary to perform a heart transplant with the lung or soon after, to ensure improvement of symptoms.
Most often, these diseases can be treated with simpler and less invasive treatments, such as tablets or breathing apparatus, but when these techniques no longer produce the desired effect, transplantation may be an option indicated by the doctor.
When the transplant is not recommended
Although transplantation 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, a history of cancer or severe kidney disease. In addition, if the person is unwilling to make the lifestyle changes necessary to combat the disease, transplantation may also be contraindicated.
How is the transplant done?
The transplant process begins well before surgery, with a medical evaluation to identify if there is any factor preventing the transplant and to assess the risk of rejection of the new lung. After this evaluation, and if it is selected, it is necessary to stay on a waiting list for a compatible donor in a transplant center, such as InCor, for example.
This wait may take from a few weeks to several months according to some personal characteristics such as blood type, organ size and disease severity, for example. When a donor is found, the hospital contacts the person who needs the donation to go to the hospital within a few hours and have surgery. In this way, it is advisable to always have a suitcase ready for use in the hospital.
Already in the hospital, it is necessary to make a new evaluation to ensure that the surgery will be a success and then begins transplant surgery.
What Happens During Surgery
The surgery for lung transplantation is done 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 the airway of the lung, then the new lung is placed in the place and the vessels, as well as the airway, are again connected to the new organ .
Since it is quite extensive surgery, in some cases, it may be necessary to connect the person to a machine that replaces the lungs and heart, but after surgery, the heart and lungs will again function without help.
How is the transplant recovery?
Lung transplant recovery usually lasts for 1 to 3 weeks, depending on the body of each person. Soon 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 properly. However, with the advancement of days, the machine becomes less necessary and the hospitalization can pass to another wing of the hospital, not needing to continue in the ICU.
During the entire hospitalization, the drugs will be administered directly into the vein, to reduce the pain, the chances of rejection and also to reduce the risk of developing an infection, but after discharge, these medications can be taken in the form of tablets, until the recovery process is complete. Only immunosuppressive medicines should be kept for life.
After discharge, it is necessary to make several visits to the penumologist to ensure that the recovery is going well, especially during the first 3 months. In these consultations, it may be necessary to perform several tests, such as blood tests, X-rays or even electrocardiograms.
