A lung transplant is a surgical procedure to replace diseased lungs. To be a candidate, you must meet certain medical criteria and agree to take immunosuppressive drugs.
Immunosuppressive drugs prevent your body from rejecting the new lungs. But they can also cause dangerous infections. You’ll need to get regular blood and lung tests.
1. The Better the Donor
While it’s not the only factor, age is one of the biggest obstacles to getting a lung transplant. There are currently more people waiting for a lung transplant than there are transplantable lungs available. This means that the medical community is working hard to increase the number of lungs available for transplant, especially in younger patients who are better candidates for surgery.
Before a patient receives a lung transplant, they have to undergo a rigorous screening process that includes recent computed tomography (CT) scans and chest X-rays, blood tests, tissue typing, ventilation perfusion testing, and more. They’ll also have to take powerful immunosuppressants that prevent their body from rejecting the new lungs. crazyga
The lungs aren’t always perfect, so doctors have to make tough choices when choosing the best ones for each patient. They’ll usually avoid giving a patient a lung graft from a donor with significant smoking history because they know that it’s likely to have worse long-term survival than a graft from a non-smoking donor. But recent research shows that some older patients can have acceptable outcomes when they receive lungs from donors who meet extended criteria.
2. The Better the Patient
The most important factor for lung transplant survival is the patient's health at the time of surgery and following up with regular doctor appointments and cancer screenings. A common problem is organ rejection, which can happen at any time after the surgery and needs to be monitored carefully. It usually happens because the new lungs aren't a good match for the patient's system. This is why it's so important to avoid smoking and take all the immunosuppressant medications prescribed by your doctor.
Lung transplantation is recommended only for those who have a disease or condition that prevents them from breathing normally and have not responded to other treatments. These include cystic fibrosis, pulmonary fibrosis, emphysema, a1-antitrypsin deficiency, bronchiectasis, sarcoidosis and pulmonary hypertension. It is also sometimes needed for those with severe heart birth defects that cause advanced lung disease such as pulmonary veno-occlusive disease, right ventricular failure and ventricular septal defect.
While older patients have a lower chance of 1- and 3-year survival than those under 65, careful candidate, donor and procedure selection can maintain equivalent or near-equivalent morbidity and mortality in both groups. This is especially true since the 2005 revision of the LAS scoring system that weighs anticipated 1-year survival without transplant-known as wait list urgency-twice as much as age does in the calculation.
3. The Better the Transplantation
A lung transplant can significantly improve a patient’s quality of life and extend their lifespan. However, it’s not without its risks. Infection and organ rejection are the main threats. Both are more common in the first year after surgery.
Before you undergo transplantation, you must meet certain criteria. Your medical team will evaluate you to see if a lung transplant is the best option for you. They will look at your condition, whether you need a single or double lung, and what kind of donor you might receive.
After the surgery, you’ll spend 1 to 5 days in intensive care. During this time, your healthcare providers will monitor you and make sure your body is accepting the new lung. They’ll also place small tubes in your chest that drain blood, air and fluid to help the new lung(s) expand fully.
You’ll need to follow your health care team’s instructions after the surgery, including eating a healthy diet and not smoking. You’ll also have to take medications to prevent your body from rejecting the transplanted lungs.
4. The Better the Care
Lung transplant surgery can be a lifesaver for people with severe lung diseases, such as cystic fibrosis and pulmonary fibrosis. It can improve quality of life, but it also carries serious risks and requires long-term use of anti-rejection medications. Follow your transplant surgeon and transplant pulmonologist’s instructions before and after surgery to lower your risk. Call your doctor if you have a temperature of 100degF or higher; a cough that doesn’t go away; any other symptoms or signs; a new lump or sore; or if you develop any other health problems, such as cancer, that could be related to your transplant.
While age is a factor in lung transplant survival rates, it doesn’t mean you can’t receive a lung at an older age. A study from UCLA Medical Center reveals that select patients aged 65 and older can safely undergo lung transplantation with acceptable outcomes. However, it is important to know that survival rates after a lung transplant depend on the type of facility you attend and the quality of your care after surgery.
5. The Better the Support
It’s important for lung transplant patients to have a supportive network of family and friends. They will need to travel and visit their doctors for routine appointments, as well as reevaluation visits to ensure they stay eligible for the transplant. These appointments can be difficult to manage, especially when a patient’s COPD symptoms are getting worse.
Although lung transplant surgery may help some people with severe lung disease breathe easier and live longer, it is a major medical procedure with serious risks. It is also a long-term commitment because recipients have to take immunosuppressants that can increase the risk of other health problems, including cancer. However, many older patients with emphysema are proving that age doesn’t necessarily mean a poor prognosis when it comes to lung transplantation. In fact, a study published this month in the Journal of Thoracic and Cardiovascular Surgery found that select lung transplant centers can safely perform transplants on patients over 65. Lois Tumanello, for example, is now 66 and a transplant recipient. She had suffered from emphysema for nine years before receiving her single-lung transplant at UCLA Medical Center in 2007. Tumanello is now happy and healthy, thanks to the gift of her new lungs.
6. The Better the Medications
Once you have a lung transplant, you’ll need to take powerful immunosuppressants to prevent rejection of the new lungs. These medications can have serious side effects and may increase your risk of other health problems.
You’ll also have to take regular tests and get regular follow-up care, including screening for cancer. Your doctor will help you set up a schedule.
While survival rates have improved in recent years, they still don’t match those of other solid organs. That’s mainly because lungs are very fragile. In addition, older patients have higher mortality rates.
Despite stringent selection, lung transplantation in older people is associated with increased mortality (excess annual mortality ratio older/younger of 1.9) (1,2). This is primarily due to competing risks such as atherosclerosis, dementia, osteoporosis, COPD, malignancy, and need for renal replacement therapy after lung transplantation (2,3). Nevertheless, the use of a bilateral transplant in patients 74 is associated with improved overall survival (3,4). Nonetheless, a single transplant remains the treatment of choice in patients 70 with obstructive or restrictive disease.
7. The Better the Environment
Lung transplant surgery can greatly improve the quality of life for people with severe lung disease. The procedure can help them breathe more easily and live longer, but it does come with serious risks and requires a lifetime of anti-rejection medications.
Survival rates vary by facility, so patients should consider all options when choosing where to have their surgery. Lung transplant surgeons have made a number of improvements to the operation over the years, including the use of a technique called ex-vivo lung perfusion, which allows donor lungs to be kept alive outside of the body while they’re being evaluated for compatibility. This has allowed doctors to transplant lungs that they would have otherwise been unable to find, says UCSF’s Jasleen Kukreja.
However, researchers are still working on how to reduce the risk of rejection after a lung transplant. One area where they’re making significant progress is in the way they monitor patients, both before and after surgery. They’re also examining the use of medications to prevent rejection and other complications, which can affect long-term outcomes.
8. The Better the Health Care
The success of lung transplant surgery is largely determined by how well you follow your doctor’s instructions for post-transplant care. That means getting regular medical checkups and recommended cancer screenings. It also means taking medications as directed, including immunosuppressants that prevent your body from rejecting the new organ.
If you have severe lung disease and other treatments are no longer working, a lung transplant may be an option. But it’s a treatment of last resort. You need to go through a long evaluation process, wait on the waiting list and undergo the surgery itself. And then you must take life-long medications to prevent rejection.
To do that, you need to live close to a transplant center so you can get to regular appointments with your doctors. That can be difficult and requires a team of supportive family and friends. You should also make healthy lifestyle choices like eating a nutritious diet and staying physically active. These may help you live longer with your new lungs. And don’t forget to always get your routine blood tests done.