The lungs are a complex organ. It can be differentiated into the left and right lung. Depending on the type of discomfort and the degree of damage, a transplant will replace one wing, both wings, or individual lung lobes.
The aim is to replace the defunct tissue with a healthy organ so that the vital processes can continue and the life of the patient can be saved. However, before a lung transplantation is used, the disease must be well advanced and untreatable with medications and other therapies. On the one hand, the proportion of donor organs is scarce, and on the other hand, the risks of a lung transplantation predominate in less severe cases.
The basis is a detectable respiratory distress of the patient and a life expectancy, which is less than 18 months without a donor organ. The damage to the tissue is caused by various diseases. These include, for example, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease or pulmonary hypertension. However, lung transplantation is the last resort for any disease.
Before the transplantation can take place, many patients often already have a long ordeal, which consists mainly of the waiting list. Who receives one of the limited donations and who does not, depends on numerous factors and tests. These include, for example, the age of the patient and the general state of health. If the transplant has been approved, the preparation time will be reached before the operation.
The goal of this phase is to minimize the individual risk of the person concerned as much as possible. For this purpose, the thoracic area is examined by X-ray and CT. It comes to lung function tests and examinations of the heart. In order to rule out the presence of tumors and infections, there is also a laboratory examination of the blood. The preparation time is completed by a psychological report, a transplantation is an emotional burden. Based on the documentation, it is finally decided within which period of time the operation should take place. If a suitable donor organ has been found, the procedure is initiated immediately.
In most cases, transplantation of both lungs occurs. The operation of only one can cause a serious infection. In order to remove the tissue, a cut is first made on the thorax. Through the opening of the diseased part can be removed and the healthy organ to be used. First, the doctors connect lung bronchi and pulmonary veins, then the pulmonary arteries. If it is possible for the blood to circulate again, the new lung takes on its function. If the transplant has been successfully completed, the tissue is sutured.
After completing the operation, the patient must first stay in the intensive care unit. In general, a shift to another station within a week is desired. However, in about 15 percent of all lung transplants, complications occur that necessitate a longer stay in the intensive care unit. The transplant is accompanied by a 3-week hospital stay with rehabilitation measures. Patients must take medicines that prevent the organism from shedding the new lung.
The aim of the operation is to allow the disturbed gas exchange to run smoothly again. Once the procedure has been successfully completed, the body is again able to supply the cells optimally with oxygen and at the same time eliminate the accumulated waste products.
As with any surgery, there are health risks associated with lung transplantation. These are already caused by the anesthesia. Thus, complaints such as thrombosis or infections can not be excluded. Unclean seams can lead to leaks and bleeding into the tissue.
Studies have also shown that about 30 percent of all patients during their lifetime with the new lung at least once perceive an acute rejection process of their body. In this case it comes to an inflammation, because the organism does not recognize the new tissue as the body's own cells. Instead, he produces antibodies to destroy the supposed foreign body. These attack the lungs, it develops an inflammation. Patients notice the reaction due to fever, a dry mouth, impaired organ function, fatigue and shortness of breath.
Treatment with antibiotics and immunosuppressants often eliminates the phenomenon. Especially in the first year after the operation patients complain more often about infections with viruses, fungi and bacteria. Decisive for the frequent occurrence is the weakened immune system. In this way, pathogens can easily penetrate into the body and trigger diseases there.
A lung transplantation can cause respiratory complications. These are often based on narrowed airways, which in turn are based on the interfaces. However, there are now medical procedures that have reduced the incidence of such symptoms. These include, for example, stents that the body degrades after some time, or small balloons. In order to be able to recognize the numerous possible risks at an early stage, regular check-ups are inevitable. In these patients blood is taken, the function of the lung is tested and the appearance of the bronchi is considered.