Our Summary

This research paper is about lung transplants, which are a common treatment for people with severe lung disease. If a patient with severe lung disease has less than a 50% chance of surviving the next two years without a transplant, but over an 80% chance of surviving the next five years with one, a transplant should be considered.

The paper discusses how patients are cared for in the intensive care unit after the surgery. It covers how to manage complications that can occur after a lung transplant. These include acute kidney injury, irregular heart rhythms, blood clots in the veins, dysfunction of the transplanted lung, a syndrome causing high levels of ammonia in the blood, and low platelet count.

The paper also talks about managing long-term issues that can arise after a lung transplant. These include diabetes, high blood pressure, and narrowing of the airways.

In simpler terms, this research provides a guide on how to take care of patients after a lung transplant, from immediate post-operation care to dealing with long-term health issues afterwards.

FAQs

  1. Who should consider lung transplantation as a treatment option?
  2. What are some potential complications following lung transplantation surgery?
  3. How are long-term issues like diabetes mellitus, hypertension, and bronchial stenosis managed after a lung transplant?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and following a recommended exercise and rehabilitation plan to aid in recovery and prevent complications. It is important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for lung surgery include those with end-stage pulmonary disease who have an expected 2-year survival of less than 50% without a lung transplant and an expected 5-year survival of greater than 80% after transplant. These patients may experience complications such as acute kidney injury, atrial arrhythmias, deep vein thrombosis, primary graft dysfunction, hyperammonemia syndrome, thrombocytopenia, diabetes mellitus, hypertension, and bronchial stenosis. Management of these complications and long-term issues is an important aspect of post-surgical care for lung transplant patients.

Timeline

Before lung surgery:

  1. Patient undergoes a series of tests and evaluations to determine if they are a suitable candidate for lung transplantation.
  2. Patient is placed on a waiting list for a donor organ.
  3. Patient may undergo preoperative counseling and education on the surgery and postoperative care.
  4. Patient may need to undergo additional tests or procedures to optimize their health before surgery.

After lung surgery:

  1. Patient is monitored closely in the intensive care unit immediately after surgery.
  2. Patient may experience complications such as acute kidney injury, atrial arrhythmias, deep vein thrombosis, primary graft dysfunction, hyperammonemia syndrome, and thrombocytopenia.
  3. Patient may be weaned off mechanical ventilation and other supportive measures as they recover.
  4. Patient may need long-term management of issues such as diabetes mellitus, hypertension, and bronchial stenosis.
  5. Patient will need to take immunosuppressive medications to prevent rejection of the transplanted lung.
  6. Patient will undergo regular follow-up appointments and monitoring to ensure the success of the transplant.

What to Ask Your Doctor

  1. What is the specific reason for recommending lung surgery in my case?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. Will I need to take medications or undergo other treatments after the surgery?
  5. What lifestyle changes, if any, will I need to make following the surgery?
  6. How will the surgery impact my overall lung function and quality of life?
  7. What is the success rate of this type of surgery for patients with my condition?
  8. How often will I need follow-up appointments or monitoring after the surgery?
  9. Are there any alternative treatments or options available for my condition?
  10. What experience do you have in performing this type of surgery, and what is the success rate at this facility?

Reference

Authors: Carney KC, Bronzell-Wynder T, Gronek K. Journal: Crit Care Nurs Clin North Am. 2019 Sep;31(3):285-302. doi: 10.1016/j.cnc.2019.05.001. Epub 2019 Jun 24. PMID: 31351551