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To determine whether lung transplant surgery is appropriate for an individual, a complete health evaluation is necessary. Typically, a patient undergoes three or four days of testing on an outpatient basis for evaluation. Depending on the severity of the patient’s illness, this evaluation could take place as an inpatient.
If the transplant physician finds that transplantation is an appropriate option, and the patient wants to receive a lung transplant, the patient will be placed on the transplant waiting list. The patient's name, blood type and body size, along with an assigned lung allocation score (LAS) will be placed in the national United Network for Organ Sharing computer at Southwest Transplant Alliance. The LAS helps determine the order in which lung offers are made to lung candidates who are 12 years or older. The score depends on the seriousness of the candidate’s medical condition before transplant and the likelihood of a successful transplant. For more information on the LAS system, visit United Network for Organ Sharing (UNOS).
While on the waiting list for a transplant, the patient will need to carry a cellphone or beeper to be contacted quickly when a donor becomes available. The patient must live within two hours of the hospital so that he or she can arrive soon after a donor becomes available. The patient should also notify the transplant office about any serious infections he or she may get, such as pneumonia, abscesses or major infections.
The amount of time a patient waits for surgery varies depending on donor availability, the patient's blood type, body size and how sick the patient is. Because of the shortage of donor organs, the waiting time for a transplant is commonly several months.
Procedure
When an appropriate donor organ is ready, the patient will be called. The patient should not eat or drink anything after getting called and must arrive at the hospital within two hours. The patient will need to be admitted and tests will be drawn immediately.
During surgery, the patient's family will be directed to a waiting room and an operating room nurse will update them during the surgery. The surgeon will meet with the family after the surgery is completed.
Recovery
Once surgery is finished, the patient will stay in the Intensive Care Unit (ICU). For the patient's protection while in the ICU, all visitors and health-care personnel will wear gowns, gloves and masks when in the patient’s room.
Generally, once the patient is breathing safely on his or her own, the patient will be transferred out of the ICU, but will probably spend another few days in the hospital. During this time, the patient will be instructed on medications, future outpatient visits and general health-care issues.
The first two to three months after the transplant are the most critical. This is the most common time for infection and rejection to occur. At first, patients will need to come to the transplant office twice a week. This makes it necessary for them to remain in the Dallas area for at least six to 12 weeks.
A lung transplant requires a long-term commitment, as patients will need to take medications for the rest of their lives, exercise regularly, eat a healthy diet, abstain from smoking, street drugs and alcohol, and have frequent medical checkups.
