Type of Surgery
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Last updated: 02/17/2009
Once a patient has been selected as a possible organ recipient, the process of waiting for a donor organ match begins. The donor organ must meet specific requirements for tissue match in order to reduce the chance of organ rejection. It is estimated...
that it takes an average of one to two years to receive a suitable donor lung, and the wait is made less predictable by the necessity for tissue match. Patients on a recipient list must be available and ready to come to the hospital immediately when a donor match is found, since the life of the lungs outside the body is brief.
Single lung transplantation is performed via a standard thoracotomy (incision in the chest wall) with the patient under general anesthesia. Cardiopulmonary bypass (diversion of blood flow from the heart) is not always necessary for a single lung transplant. If bypass is necessary, it involves re-routing of the blood through tubes to a heart-lung bypass machine. Double lung transplantation involves implanting the lungs as two separate lungs, and cardiopulmonary bypass is usually required. The patient's lung or lungs are removed and the donor lungs are stitched into place. Drainage tubes are inserted into the chest area to help drain fluid, blood, and air out of the chest.
Heart-lung transplants always require the use of cardiopulmonary bypass. An incision is made through the middle of the sternum. The heart, lung, and supporting structures are transplanted into the recipient at the same time.
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Lung transplantation is a surgical procedure in which a patient's diseased lungs are partially or totally replaced by lungs which come from a donor. While lung transplants carry certain associated risks, they can also extend life expectancy and enhance the quality of life for end-stage pulmonary patients.
While the precise details of surgery will depend on the exact type of transplant, there are many steps which are common to all of these procedures. Prior to operating on the recipient, the transplant surgeon inspects the donor lung(s) for signs of damage or disease. If the lung or lungs are approved, then the recipient is connected to an IV line and various monitoring equipment, including pulse oximetry. The patient will be given general anesthesia, and a machine will breathe for him or her.
It takes about one hour for the pre-operative preparation of the patient. A single lung transplant takes about four to eight hours, while a double lung transplant takes about six to twelve hours to complete. A history of prior chest surgery may complicate the procedure and require additional time.
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