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Lung transplant - Overview

Alternative Names

Solid organ transplant - lung

Definition of Lung transplant:

Lung transplant is surgery to replace one or both diseased lungs with healthy lungs from a human donor.

Description:

The new lung or lungs are usually donated by someone under age 65 who is brain-dead but is still on life-support. The donor tissue must be matched as closely as possible to your tissue type to reduce the odds that your body will reject the transplanted lung.

Lungs can also be given by living donors. Two or more people are needed. Each person donates a segment (lobe) of their lung to form an entire lung for the person who is receiving it.

During lung transplant surgery, you are asleep and pain-free (under general anesthesia). A surgical cut is made in the chest. Lung transplant surgery is done with the use of a heart-lung machine, which does the work of your heart while your heart is stopped for the surgery.

  • For single lung transplants, the cut is made on the side of your chest where the lung will be transplanted. The operation takes 4 - 8 hours. In most cases, the lung with the worst function is removed.
  • For double lung transplants, the cut is made below the breast and reaches to both sides of the chest. Surgery takes 6 - 12 hours. Tubes are used to send blood to a heart-lung bypass machine to provide oxygen and move blood through the body during the surgery.

After the cut is made, the major steps during lung transplant surgery include:

  • One or both of your lungs are removed. For patients who are having a double lung transplant, most or all of the steps from the first transplant are completed before the second transplant is done.
  • The main blood vessels and airway of the new lung are sewn to your blood vessels and airway. The donor lobe or lung is stitched (sutured) into place. Chest tubes are inserted to drain air, fluid, and blood out of the chest for several days to allow the lungs to fully re-expand.

Sometimes heart and lung transplants are done at the same time (heart-lung transplant) if the heart is also diseased.

Why the Procedure Is Performed:

A lung transplant is usually the last-resort treatment for lung failure. Lung transplants may be recommended for patients under age 65 who have severe lung disease. Some examples of diseases that may require a lung transplant are:

Lung transplant may NOT be done for patients who:

  • Are too sick or badly nourished to go through the procedure
  • Continue to smoke or abuse alcohol or other drugs
  • Have active hepatitis B, hepatitis C, or HIV
  • Have had cancer within the past 2 years
  • Have lung disease that will likely affect the new lung
  • Have severe disease of other organs

The doctor may recommend against a heart transplant if there is concern that you will not be able to keep up with the many hospital and doctor's visits, tests, and medications needed to keep the new heart healthy.

  • Reviewed last on: 5/4/2011
  • Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Smythe WR, Reznik Si, Putnam JB Jr. Lung (including pulmonary embolism and thoracic outlet syndrome). In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 59.

Solomon M, Grasemann H, Keshavjee S. Pediatric lung transplantation. Pediatr Clin North Am. 2010; 57(2):375-391.

Flume PA, Mogayzel PJ Jr, Robinson KA, Rosenblatt RL, Quittell L, Marshall BC; Clinical Practice Guidelines for Pulmonary Therapies Committee; Cystic Fibrosis Foundation Pulmonary Therapies Committee. Cystic fibrosis pulmonary guidelines: Pulmonary complications: hemoptysis and pneumothorax. Am J Respir Crit Care Med. 2010; 182(3):298-306.

Kotloff RM. Lung transplantation. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 95.

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