Wednesday, June 1, 2011

Lung Transplant Information #4 - Being Called In for Transplant

We have reviewed the Evaluation, Listing and Waiting on the List processes for a lung transplant. Again, the process is:


Evaluation
Listing
Waiting on the List
Being Called in for Transplant
Life after Transplant

The most important thing to be is READY for anything when being called in for a transplant. Since the lungs are not taken out of the donor yet, if the lungs are damaged or not viable after removal, there may be a dry run. The person to receive the lungs is all ready to go and the process stops. Better to wait for the best and the healthiest lungs possible. It is important to know that the allocation number is kept, even if one is sent home due to a problem with the donor’s lungs.

The receiver of the new lungs is given all the needed tests and prepped for surgery.

Then, it happens. But, there is a choice – Single Lung or Double Lung.

The majority of lung transplants are both lungs. But, there are three reasons why there would be a single lung transplant:
  1. The person is over 60. It is an easier surgery and recovery.
  2. If the receiver anatomy or history prohibits a double lung transplant.
  3. If the receiver is close to death and one lung becomes available, that is an option. 
The surgery itself for a double lung transplant usually begins with a “clamshell” incision. It goes from armpit to armpit with a rise like an arch. If the receiver has had heart surgery, the surgeon will use the scar and open at the same spot. If only one lung is being transplanted, the incision will be low over the side of the ribcage on the side of the transplant.

The average surgery is 6 to 8 hours if there are no complications.

There are the normal risks associated with any surgery.

Immediately, immunosuppressant drugs are introduced during the transplant surgery. The receiver will be on these drugs for the rest of their life.

Once the surgery is over, the new lung owner is on a ventilator in ICU with a central IV line in the neck or shoulder and there are staples holding the incision together covered in gauze. There will be 3-4 chest tubes to remove fluid from the chest cavity, a catheter in the bladder and those crazy socks on the legs to keep the fluid moving throughout the body to decrease the possibility of blood clots.

The people in ICU will have the patient up and walking within 24 hours. The normal stay in ICU is 3-5 days. Really rather remarkable. The total hospital stay is only 7-14 days.

Tomorrow, I will write about the transition from the hospital to home after a transplant.

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