Lung Transplantation

Overview :

Once a patient has been selected as a possible organ recipient, the process of waiting for a donor organ match begins. The donor organ must meet clear requirements for tissue match in order to reduce the chance of organ rejection. It is estimated that it takes an average of one to two years to receive a suitable donor lung, and the wait is made less predictable by the necessity for tissue match. Patients on a recipient list must be available and ready to come to the hospital immediately when a donor match is found, since the life of the lungs outside the body is brief.

Single lung transplantation is performed via a standard thoracotomy (incision in the chest wall) with the patient under general anesthesia. Cardiopulmonary bypass (diversion of blood flow from the heart) is not always necessary for a single lung transplant. If bypass is necessary, it involves re-routing of the blood through tubes to a heart-lung bypass machine. Double lung transplantation involves implanting the lungs as two separate lungs, and cardiopulmonary bypass is usually required. The patient's lung or lungs are removed and the donor lungs are stitched into place. Drainage tubes are inserted into the chest area to help drain fluid, blood, and air out of the chest. They may remain in place for several days. Transplantation requires a long hospital stay and recovery can last up to six months.

Heart-lung transplants always require the use of cardiopulmonary bypass. An incision is made through the middle of the sternum. The heart, lung, and supporting structures are transplanted into the recipient at the same time.