LUNG TRANSPLANTATION

A lung transplant is surgery to replace one or both diseased lungs with healthy lungs from a human donor. Lung transplants may be recommended as last resort treatment options for patients with lung failure diseases such as cystic fibrosis, pulmonary fibrosis, emphysema, COPD or pulmonary hypertension.

Lung transplants require lungs to be donated by someone who is declared brain-dead but who remains on life support. This life-giving treatment is therefore entirely dependent on the generosity of a grieving donor family. Organ donation rates remain the major limitation on the number of patients who can receive a transplant.

A pre-transplant evaluation is conducted before potential applicants undergo transplant surgery to give complete information about the patient’s overall health and eligibility to receive a lung transplant. An evaluation is very intensive and includes a complete physical in which the respiratory, cardiac, kidney and immune systems are assessed. In addition consultations are arranged with pulmonary transplant physicians, surgeons and physicians specialising a range of other areas including cardiology and infectious diseases. A series of tests are arranged including:

• CT scan
• Pulmonary function tests
• Echocardiography and often coronary angiography
• Kidney function tests
• Evaluation of the immune system
• Routine and speciality medical tests
• Blood and tissue typing
• Exercise studies.

Test results are screened and assessed to determine the likelihood of a successful transplant. Lung transplants are not recommended for patients with serious illnesses such as reduced liver or kidney functioning or other serious diseases. Patients who are not considered eligible transplant candidates will be offered alternative medical or surgical care if there are any available.

However patients are considered eligible if they can be expected to undergo a transplant with a reasonable margin of safety. However even after a patient is considered an eligible candidate, a long period of waiting often ensues prior to surgery whilst a suitable donor is located. Some patients only wait days or weeks for their transplant but generally most recipients wait between 12 – 18 months. During this waiting period transplant patients are re-evaluated at least once every three months. Unfortunately not all patients who are accepted onto the waiting list will actually receive a transplant as some patients deteriorate to the point where they cannot safely receive a transplant.