Edited by Dr. Kapil Patel, Medical Director for the TGH/USF Center for Advanced Lund Disease & Lung Transplantation
Lung transplant is an option “of last resort”. A transplant is recommended when the condition of the patient’s lungs is irreversibly damaged, and your quality of life and/or life expectancy is limited.
This is up to you. Remember, though, that if you are seen in the transplant center your own physician has referred you (first opinion) and before your consult a transplant pulmonologist has already reviewed your records (second opinion) and determined that you are possibly a candidate for transplant. Insurance companies will often pay for a second opinion.
Not always. A patient must undergo a regimen of tests to ensure he or she is sufficiently strong enough to handle not only the operation but the various procedures that come before and after transplant. It is also important to determine if the patient will be 100 percent compliant with all that is expected to make the entire process a success.
There are organizations that assist patients in obtaining funds. However, lung transplantation can be costly and anti-rejection medications are expensive as well. If the patient is resourceful, a combination of financial strategies may result in sufficient funds being raised for the procedure.
It is impossible to predict how long your wait time will be. The time you are on the list depends on how many others are waiting for a lung in the same height and blood type as you are. Your wait time can range from a few days to a few years depending on your LAS and your disease. Every effort is made to find compatible lungs in the shortest amount of time.
You may not undergo a transplant procedure if you are ill. Ultimately the decision will be made by your transplant team. However, it is necessary that you be in a healthy state for this operation. Once you are on the waiting list you should inform your transplant center of any changes in your condition.
Sometimes, things that treat your lung disease can interfere with your ability to have a transplant. The evaluation process and results of tests will determine with certainty your ability to have a lung transplant.
It is not likely that a lung which had already been transplanted would be used a second time. However, this would be a decision that your medical team would make.
Once stabilized, your breathing should be better than ever. You may require some oxygen for a short period of time after transplant.
You may experience some side effects from the anti-rejection medication, but we will make adjustments as needed to minimize these. There will be some restrictions in activities in the months following your operation, but you should be able to resume a normal functioning life after the first few months.
As stated above, gradual rehabilitation should get most people to a level of activity they were used to before they developed lung disease. Of course, there are boundaries in activities you may participate in and your transplant team will discuss these with you.
Your anti-rejection medication levels are very closely monitored, especially the first few months after transplant. Once you have recovered and gone through prescribed rehabilitation activities your energy levels should normalize.
You will be immunosuppressed for the rest of your life and will have to continue to take certain precautions. Your transplant team will assist you with any questions regarding diet, medications, and activities that may interfere with your transplant. All changes in your medications or additions to your medications should be cleared by a member of your transplant team.
If I have a transplanted lung and I need unrelated surgery such as a hernia repair or something more serious like a coronary artery bypass, would there be any complications with that? Will there be special measures taken?
Getting health insurance is difficult for anyone who has serious medical problems. You should never change your insurance without notifying your transplant team because your new insurance may not cover necessary medications and procedures related to your transplant. You are highly encouraged to keep your current insurance because it may be the best policy you will ever have. Our social workers and financial coordinators will be available to assist you.
In medicine, anything can happen. Your immune system is suppressed so it is at a higher risk of developing cancer, infections, and other medical problems. However, detailed measures are taken to ensure a patient receives a very healthy lung. You must be very compliant in making lifestyle changes that do not encourage medical problems related to the lung. In certain situations, particularly in complications regarding rejection issues, a second transplant can take place.
No, it is not more common but the consequences of them can be greater. Transplant patients are educated on measures to take to decrease their risk of exposure.
They do not need to avoid high altitudes, but certain precautions need to be taken. You should always talk with your transplant team prior to traveling. Special masks need to be worn when traveling on airplanes.
Areas of asbestos, dust, heavy smoke, etc can be damaging even to individuals without a lung transplant. Transplant patients should always avoid these exposures to the best of their ability. If you must be in such conditions, you are advised to wear a mask with appropriate filtration in it to avoid excessive inhalation of this type of material. If the air in your area gets particularly smoky, it is best to remain indoors until it clears.
If you have a medical condition that may require special attention in an emergency, then it is always a good idea to wear a Medic Alert bracelet. After transplant it will let emergency personnel and doctors know you are a lung transplant patient and require important medications that must be administered in a timely fashion.
A human can function sufficiently with just one lung although two are sometimes preferred. The testing you complete during your evaluation will help your transplant team determine if you can receive a single or double lung transplant. Age and how urgently a patient needs a lung transplant are other factors that are taken into consideration.
In a single lung transplant usually, the lung that is most diseased is removed. Your other native lung will remain in your chest cavity. Blood will flow to the area of least resistance- in your case- the transplanted lung.
This is done in rare cases. There are very strict laws and medical protocols associated with the donation and transplantation of organs that must be followed carefully. There are always exceptions that can be made in extreme cases but those are decided by a team of medical specialists.
It can but it is not common. Advanced lung disease can cause stress to other organs, especially the heart. Normally after your lungs are transplanted it relieves these other organs of that stress.
Every case is different, and your doctor will discuss this with you. Many factors contribute to your life expectancy post-transplant. The goal of transplant is to extend your life expectancy and improve your quality of life as well.
After transplant you will be on immunosuppression medications for the rest of your life. The dosage of these medications may decrease over time.
Our goal of transplant is to extend your life expectancy after transplant and your team takes special consideration when choosing donor lungs for you.
Your transplant team, especially your social worker, will assist you if an issue should arise. Some drug companies offer financial assistance for patients who qualify.
Transplantation is certainly not a cure for serious allergy problems. The immunosuppression medications may in some cases suppress some of your allergic reactions, but these reactions do not usually affect the transplanted organ. The transplant team will help you deal with this problem as much as possible
Time will vary depending on the donor location and donor OR time. It is important for you and your family to come to the hospital as soon as possible once you are notified an organ is available. The donor coordinator will provide you the necessary information when they contact you. It is helpful to already have a bag packed and ready to go for when you do get the call.