At the University of Maryland Medical Center, the lung transplant team is dedicated to providing the best possible experience for patients who need a lung transplant, when conventional medical therapy cannot improve the function of their lungs.
It is important to understand upfront that lung transplantation does not “cure” lung disease. Transplanted patients will still need daily medication and rigorous follow up by the transplant team for the rest of their life.
Every candidate seeking lung transplantation is carefully evaluated and thoroughly educated. The pre-transplant evaluation can be complex and time consuming. Post-transplant management can be difficult and demanding. You and your family must completely understand the risks, limitations and benefits of transplantation before making an informed decision concerning moving ahead with this operation.
The lungs provide your entire body with oxygen and remove carbon dioxide. When lungs can no longer exchange oxygen and carbon dioxide, a patient is considered in end-stage lung failure and lung transplantation is considered.
Several different diseases can lead to end-stage lung failure including chronic obstructive pulmonary disease (COPD), interstitial lung disease, and primary pulmonary hypertension
Once you have been referred for a transplant evaluation, a clinic visit will be scheduled. At your first visit, you will meet Transplant Pulmonologist Dr. Aldo Iacono and Transplant Coordinator Brian Sherman RN. You will be interviewed, examined, and counseled about your options for care. This may or may not include a full evaluation for lung transplantation. The realities of having and living with a lung transplant are explained and discussed. If it is decided to proceed with more evaluation, additional testing will be scheduled. Testing may include but not limited to:
There are many members of the lung transplant team. Each is important because they bring special knowledge and expertise to help you during all phases of the transplant process.
This doctor will actually perform the lung transplant operation. Along with your pulmonologist, the surgeon will closely monitor your care before and following surgery
This doctor monitors your care before and after surgery. The pulmonologist is skilled in treating lung disease and determining whether a transplant would be beneficial. After surgery, the pulmonologist will visit you in the hospital and monitor your care.
Transplant Nurse Coordinator
This is a nurse who is responsible for “coordinating” your care through the transplant evaluation process up until transplantation. The transplant coordinator acts as a liaison between you and your doctors.
Transplant Nurse Practitioner
The transplant nurse practitioner oversees the details of your care after transplantation including medications, laboratory and other test results, and collaborates with your physician to provide ongoing management of your care.
Transplant Administrative Assistant
The transplant secretary is the record keeper for the transplant team. Responsibilities include scheduling tests, clinic visits, and communicating messages to other members of the transplant team.
Transplant Social Worker
The transplant social worker will help you with the “social aspects” of your care. The social worker can provide information on insurance, and the financial part of the transplant. The social worker can also help arrange transportation, lodging and support services for you and your family.
The physical therapist will help you plan a physical activity program to follow during your hospital stay and at home.
Other Members of the Transplant Team
During your hospital stay you will meet many new people including nurses, resident doctors, the dietician, the psychiatrist, the respiratory therapist, and other personnel as needed.
After extensive diagnostic testing and consultation with several different members of the transplant team agree that the benefits of lung transplantation outweigh the risks, will proceed with listing you for a donor lung. Due to the critical shortage of organs, a patient can wait up to two years for a donor organ to become available. Often patients can wait at home during this time. Unfortunately we are unable to predict when you will be offered a donor lung.
While you are on the list, you need to continue to see your pulmonologist on a regular basis. Your status on the list is determined by a score called the “lung allocation score” that is calculated based on specific data that is obtained by the transplant coordinator. Please schedule and keep your appointments with the pulmonologist so we may ensure that you are in the best possible condition prior to transplant. Your physician will determine the frequency of your visits. COMPLIANCE with maintaining and optimizing your health is PARAMOUNT in successfully undergoing transplantation.
When a donor lung becomes available, a transplant coordinator will phone you at home first. We must have a telephone number that will always reach you or someone else who can immediately contact you. We will tell you that we have a potential donor, and then ensure that you have not been ill, or have any reason why we should not perform the transplant operation. The first call you get does not always mean the transplant will happen. The surgeon must first examine the donor lung, and may find that the organ is not strong and healthy. It is always a possibility that we will prepare you for transplant surgery, and that the surgery may not occur.
Now that you have successfully come through your surgery, it is important that your new lung/lungs continue to work properly. Your immune system is responsible for protecting your body against foreign objects such as infections and transplanted organs. After your transplant, your immune system must be suppressed to prevent rejection of your new organ. This is done by taking medications called immunosuppressants. Immunosuppressants (Cyclosporine, Prograf, Prednisone, Cellcept, and Imuran) are drugs that must be taken daily for the rest of your life. It is important that they are taken exactly as prescribed to maintain a balance. Taking too little medicine will allow rejection to occur and too much will alter your body’s ability to fight off infections.