Lung transplant: indications and contraindications
Lung transplant is a complex operation that supposes replacing malfunctioning one or both lungs, or their parts with the healthy ones. Surgeons of the world's lung transplant centers take the lung or its part from a living (in this case only the fraction is taken) or a deceased donor.
The procedure is assigned to people with:
- lung cystic fibrosis — genetic disease that affects certain glands
- bronchopulmonary dysplasia or chronic obstructive pulmonary disease (COPD) — lung malfunctions that disrupt normal breathing
- pulmonary hypertension — a condition that refers to high blood pressure in the lung arteries
- pulmonary fibrosis — too much scarring tissue in the lungs leads to shortness of breath
- heart malfunction — some heart conditions cause lung diseases that may lead to heart+lungs transplantation.
The operation has following contraindications:
- smoking or drug addiction
- psychiatric issues that makes a patient legally incompetent
- an absence of accompaniment for support (it's obligatory)
- infection or disease that cannot be completely cured
- cardiac issues
- metastatic cancer
- serious life-threatening conditions that will not be treated by transplantation
- lung transplant centers won’t accept people over 55 years old.
If you are going to undergo the procedure, be ready for constant monitoring in lung transplant hospitals and take immunosuppressants during the whole life.
Survival rates in best hospitals for lung transplant
Donor options in lung transplant centers
There are 3 possible types of donors for the operation:
- Deceased donor. In most cases, organs for transplantation come from a deceased person, upon the agreement of donor’s relatives. These donors are called cadaveric. They usually have the heavy cranial trauma. Lung transplant hospitals make sure donor’s vital processes are still functioning, providing enough time for recipients allocation. After that, numerous blood tests are made to match the donor with a recipient.
- Donors who died due to cardiac arrest (DCD). The practice of using such donors was established in 2008 by lung transplant centers of excellence. Since that time it has been showing higher survival rate compared to brain-dead donors, in the recipients over a 2-year postoperative period (87% and 69% survival rates respectively).
- Living donors, who are willing to donate part of their lung. They are usually related to a patient.
Lung transplant wait time
Doctors apply so-called bridging to a transplantation, keeping a patient alive until a donor appears. This technology nullifies preoperational fatality risks and reduces the lung transplant wait time for patients.
Donation from a living donor also reduces the waiting time. It is available in such cases as:
- transplant of the whole organ is not possible due to cultural, legal or financial obstructions
- the lung waiting time is too long for a patient.
During the procedure, surgeons remove a part of the lung from 2 living donors and transplant them to a recipient.
Even the best hospital for lung transplant can’t provide a lung donor faster than within 1 year after applying to a queue. Usually, the lung transplant wait time takes around 4-8 months.
Lung transplant programs
The lung transplant programs usually consists of such steps as:
- Pre-waitlist evaluation
It is the 1st step after your arrival to the best hospital for lung transplant. There a medical team carries out an evaluation process. The team consists of a pulmonologist (a doctor who specializes in treating of the lungs), surgeon, social worker, psychiatrist, psychologist, and one or more assisting nurses.
Specialists provide this step to determine if you are a good candidate for the procedure. After a positive conclusion, you are included into a waiting list. During the lung transplant wait time you should stay in near vicinity of the hospital.
Pay attention! India is the most loyal country in the lung transplant for international patients. The wait time here is the same for both citizens and medical tourists.
- Lung transplant procedure
The surgery takes 6 -12 hours. The duration depends on some factors: type of operation, doctor’s experience, your health condition. You stay under general anesthesia.
When the surgery is complete, experts insert a special tube in the chest to remove air, drain fluid, and blood from the operation area to let the lungs function.
- Postoperative period
Right after the surgery, you have to stay in the intensive care unit (ICU). It is a special department of lung transplant centers for constant monitoring and instant reaction to condition worsening. Duration of stay in the ICU varies.
When your condition is stabilized, you are sent to a specialized care unit within a hospital. You stay under constant observation. During the hospitalization, you are provided with information about medications, diet, activity regimen, and other specific guidelines.
The postoperative hospital stay lasts 7-14 days, but the period may be extended depending on the health condition.
- Follow-up care
In 2 weeks you left the lung transplant center and return home. You should follow doctors' recommendations on how to bathe, keep surgical incision area clean and dry. There are certain restrictions: don't drive and perform physical activities for a period specified by a physician.
Follow-up visits in the best hospital for lung transplant include a great range of tests and the rehabilitation program. They may last for months, but usually take no more than 8 weeks.
Lung transplant outlook
After the operation, you need to take immunosuppressors for a lifetime to avoid organ rejection.
Survival rate in the best lung transplant centers is up to 85% in the first 3 years after the procedure. The average life expectancy for patients with bilateral lung and heart transplant is over 6 years.
Pricing in lung transplant centers of excellence
Prices for the procedure in the best lung transplant centers depends on:
- patient's condition
- type of the operation
- surgeon's qualification.
Pediatric lung transplant centers usually set their prices higher due to increased risk of complications, higher demands for medical attention, and rehabilitation facilities.
Best lung transplant centers in the world arrangement with Bookimed
Bookimed International Patients Support Center cooperates with the best lung transplant hospitalss around the world. Submit a request on the site and our Medical Doctor will contact you to provide consultation on the matter.
You will receive assistance in choosing an appropriate clinic and treatment plan, as well as scheduling your hospital stay. Bookimed will also help you process all medical documentation and coordinate your trip in the chosen country.