Lung Transplants

The lung transplant process is broken up into five stages.

1) Diagnosis: Here the patient is diagnosed with some type of fatal lung disease. Some of the most common include: Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), Cystic Fibrosis, Bronchiectasis, Pulmonary Hypertension, Sarcoidosis, and Lymphangioleiomyomatosis.
(Don has sarcoidosis)

2) Waiting List: The patient is then put on a transplant recipient list. In order to qualify to be on this list, the patient must meet several standards. Some of these include: being physiologically 60 years of age or less for bilateral lung transplantation and 65 years of age or less for single lung transplantation, poor medical prediction with only an 18 to 24-month estimated survival time, cancer free for a minimum of two years, having no other life threatening diseases, can not smoke, and must show a good potential to recover.

If the patient meets these requirements, they are then placed on the lung transplant list. In the past, the list was based on seniority. However, in the spring of 2005, the Organ Procurement and Transplantation Network instituted a new system. This new system actually takes the patients medical status and probability of survival into account, rather than just how long they have been on the list. The patient takes a test, which involves: the age, breathing capacity, pulmonary artery pressure, amount of oxygen required and underlying medical conditions of the patient. After the information is put into a computer, the patient is given a score between 1 and 100. The higher the score, the more priority one has. This new system will allow those who have the greatest need for a transplant to recieve their lungs more quickly.

3) Waiting Period: While the patient is waiting for a donor, they will go through a waiting period. Studies have shown that this time is the most difficult part of the entire transplant experience. In addition to feeling ill, one must find a way to pay for the transplant. Usually health insurance will pay for most of the operation, however there are many times when it will not. This is where Don's financial needs come into the picture. Don needs help paying for uninsured medical expenses. There are many ways one can raise money for the operation. For more information on how to raise money visit the "How to Help" page of this website.
It is very important for the patient to stay in touch with their doctors, and to stay close during the waiting time, since the new lungs can come in at any time.

4) Surgery: The new lungs will come from someone who is an organ donor. The organ donor usually is someone who has experienced brain death. Once the donor�s lungs are removed, they are flown to the recipient's city. The lungs need to be transplanted within seven hours from when they were taken out. The recipient will not be given a name of who the lungs have come from. Instead, he is simply told the age, gender, and condition of the donor.
The actual surgery can take anywhere from six to ten hours. For a single lung transplant, the lung which is most damaged is transplanted. In order to distinguish which lung is most damaged, a ventilation-perfusion scan is performed. This shows the amount of blood flow in different sections of the lungs. The less blood flow in different sections, the more damaged that area is. The surgeon will then make an incision on the side of the chest that the most damaged lung is on. This incision is made approximately six inches under ones armpit. The old lung is then removed through this opening, and the new lung is put in. For a double lung transplant, an incision is made across the chest beneath the breast area. The lung which is weaker is removed first and immediately replaced, followed by the other lung. Once the new lungs are in, the surgeon will connect the new lungs to the arteries and veins of the heart. The incisions are then sealed, and will take several weeks to heal. Drainage tubes are put into the patient�s chest in order to get rid of air, fluid, and blood in the chest so the new lungs can fully expand.

5) Recovery: The recovery process follows the surgery. Living with a lung transplant can be very demanding. After the transplant surgery, one faces the issues of rejection and infection. One�s body will think of the new lung as �foreign�, and will want to destroy it. This is known as rejection. In order to prevent this from happening, one will be treated with immunosuppressants, which are medications that interfere with the body�s normal immune response. Most patients will end up taking immunosuppressants for the rest of their lives since the risk of rejection never fully goes away. Because the immune system is trying so hard to prevent oneself from rejecting the new lung, one�s body is more likely to experience infection. Fortunately, most of the time infections can be treated with antibiotics. After the patient returns home, they should begin to exercise at a slow pace. Most recipients will have to go through physical therapy following up their surgery. After this, one will have to continue to do cardio exercise daily. The whole process is very stressful and basically takes over one�s life. After the surgery, one will not only physically have a new life but also mentally.

Survival Rates:

According to the International Society for Heart and Lung Transplantation, three year survival rates for lung transplant patients has improved over the last 15 years. In fact, more than 63% survive for at least 3 years.

*Since 1994, the number of bilateral lung transplants has been steadily increasing. In 2002, the number of bilateral lung transplants surpassed the number of single lung transplants.

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