Our Summary

Lung transplantation is a common treatment for severe lung disease. Over time, treatments to prevent the body from rejecting the new lung and to manage infections have improved, leading to better survival rates for patients. However, rejection of the new lung still happens and can lead to the lung not working properly over time. A condition called Bronchiolitis obliterans syndrome (BOS), which is a type of lung dysfunction, is the most common cause of death and health problems in lung recipients, with half of these patients developing BOS within 5 years of their transplant. Infections are also a major issue and are the most common cause of death within the first year of transplant.

The success of a lung transplant relies heavily on managing medicines that suppress the immune system to lower the chance of rejection, while also keeping a close eye on the patient for infections and other complications. It is crucial to control the natural immune response of the patient to prevent both immediate and long-term rejection. Therefore, understanding how the immune system works and how it’s connected to immediate and long-term rejection is essential for the long-term care of lung recipients.

FAQs

  1. What is the most common cause of death and health problems in lung recipients?
  2. What are the key factors for a successful lung transplant?
  3. How common is it for lung recipients to develop Bronchiolitis obliterans syndrome (BOS) after their transplant?

Doctor’s Tip

It is important for patients who have undergone a lung transplant to closely follow their doctor’s instructions for taking immunosuppressant medications, attending regular check-ups, and staying vigilant for any signs of infection or rejection. It is also important for patients to maintain a healthy lifestyle, including quitting smoking, staying physically active, and following a nutritious diet to support overall lung health. By actively participating in their care and staying informed about their condition, patients can increase their chances of a successful outcome post-transplant.

Suitable For

Patients who are typically recommended for lung transplant include those with severe lung diseases such as:

  • Chronic obstructive pulmonary disease (COPD)
  • Idiopathic pulmonary fibrosis
  • Cystic fibrosis
  • Pulmonary hypertension
  • Alpha-1 antitrypsin deficiency
  • Sarcoidosis
  • Bronchiectasis
  • Lymphangioleiomyomatosis (LAM)

Candidates for lung transplant are usually those who have exhausted all other treatment options and have severe symptoms that significantly impact their quality of life and ability to function. They must also meet certain criteria such as being physically fit enough to undergo surgery and follow the post-transplant care regimen.

It is important for patients to undergo a thorough evaluation by a transplant team to determine if they are a suitable candidate for a lung transplant and to discuss the potential risks and benefits of the procedure. Each patient’s case is unique, and the decision to undergo a lung transplant should be made in collaboration with their healthcare team based on their individual circumstances and prognosis.

Timeline

Before lung transplant:

  • Patient undergoes evaluations to determine if they are a suitable candidate for a transplant, including physical exams, blood tests, imaging tests, and psychological evaluations.
  • Patient is placed on a waiting list for a donor lung, which can take months or even years.
  • Once a donor lung becomes available, the patient undergoes the transplant surgery, which can take several hours.
  • After surgery, the patient is closely monitored in the hospital for any complications, such as infection or rejection.
  • Patient begins a regimen of immunosuppressive medications to prevent rejection of the new lung.

After lung transplant:

  • Patient continues to be monitored closely in the hospital for several weeks to months post-transplant.
  • Patient undergoes regular check-ups and testing to monitor lung function and overall health.
  • Patient must adhere to a strict medication regimen to prevent rejection and manage any side effects of the medications.
  • Patient must follow a healthy lifestyle, including quitting smoking, eating a balanced diet, and exercising regularly to maintain lung health.
  • Patient may experience complications such as infections, rejection episodes, or other health problems that require medical intervention.
  • Patient may need to undergo additional surgeries or procedures in the future to address complications or improve lung function.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung transplant include:

  1. What is the success rate of lung transplants for my specific condition?
  2. What are the potential risks and complications associated with a lung transplant?
  3. How will I be monitored for rejection of the new lung?
  4. What medications will I need to take after the transplant and what are the side effects?
  5. How often will I need to follow up with my transplant team after the surgery?
  6. How can I lower my risk of infections after the transplant?
  7. How will my immune system be managed to prevent rejection of the new lung?
  8. What lifestyle changes will I need to make after the transplant?
  9. What support resources are available for lung transplant recipients?
  10. What is the long-term outlook for lung transplant recipients?

Reference

Authors: Costa J, Benvenuto LJ, Sonett JR. Journal: Best Pract Res Clin Anaesthesiol. 2017 Jun;31(2):285-297. doi: 10.1016/j.bpa.2017.05.006. Epub 2017 May 30. PMID: 29110800