What is a lung transplant?
A lung transplant involves removing and replacing a diseased lung with a healthy lung from a human donor. Depending on the type and stage of lung disease, you may have a single lung, double lung or complete heart-lung transplant.
As well as lung transplants, further innovations to help people with lung disease include lung volume reduction surgery and lung lobe transplants.
Who is eligible for lung transplant surgery?
Lung transplants are used to treat people with advanced lung disease, where medical treatment is no longer working and quality of life is severely reduced.
Conditions treated with lung transplants include:
- chronic obstructive pulmonary disease (COPD)
- cystic fibrosis
- pulmonary hypertension
- idiopathic pulmonary fibrosis.
Since the demand for donor lungs far outweighs supply, lung transplants are undertaken on individuals who are expected to have the best success rate.
How is a lung transplant performed?
Performed under general anaesthesia, lung transplants typically take between four and twelve hours. An incision is made in the chest and the damaged lung(s) removed. A bypass machine may also be used to pump blood around the body during surgery. The new lung(s) are then connected to the appropriate airways and blood vessels and the incision closed.
Recovery after a lung transplant
Lung transplantation is a major operation and recovery can take at least three months. All patients undergoing organ transplants will need to take immunosuppressant drugs to reduce the chances of organ rejection. These drugs suppress the immune system to reduce the risk of the new organ being perceived as a ‘foreign body’.
Benefits of lung transplantation
Lung transplants have proven to be effective treatment for people with advanced lung disease, reducing symptoms of breathlessness and vastly improving quality of life. Patients with successful transplants can go onto lead near normal lives.
According to the British Lung Foundation, half of the people undergoing lung transplants survive for 5 years or more. Results at Harefield Hospital are considerably better than the international average.
Risks of lung transplantation
No medical procedure is entirely without risk, and that includes lung transplantation. The main risks following the procedure relate to organ rejection, infection and risks relating to long-term use of immunosuppressant drugs.
New surgical techniques
It is generally more difficult to match smaller people with organ donors because the donated lungs need to be small enough to fit the recipient’s lung cavities. In order to avoid wasting larger lungs for which we may have no suitable recipient, consultants at Harefield Hospital have developed two techniques to allow us to transplant parts of lungs from large organ donors into smaller recipients.
Lung volume reduction surgery
Lung volume reduction surgery involves reducing the size of the donated lung before it is transplanted by surgically trimming the lung to the appropriate size of the recipient. This technique is currently performed by thoracic surgeons in some patients as a treatment for their lung disease (emphysema); and we have already had success in using this technique for lung transplant recipients in urgent cases. The Hospital also has an active research program developing non-surgical methods of lung volume reduction.
Lobar transplantation involves transplanting only one segment (lobe) from a donor lung, rather than the whole lung. The whole lung normally has either two lobes (on the left) or three lobes (on the right). One lobe from a large donated lung may be the size of a whole lung in a small patient, and therefore the lobe may fill all the space available within the chest cavity in a small recipient.