Lung Transplant Process
Lung Transplant Evaluation
The evaluation process for a lung transplant is comprehensive. At the first visit, the patient will be evaluated by one of the transplant pulmonologists who will also review past and current medical records along with psychosocial information. The pulmonologist will determine if the patient meets the criteria for a lung transplant. The risks and benefits of having a lung transplant will also be explained to the patient and caregivers. Once it is determined the patient is a good candidate for the transplant, he or she will undergo a thorough medical, psychological and social evaluation. Once the evaluation is completed, the multidisciplinary patient selection committee will determine if a lung transplant is the best course of treatment.
Numerous tests will be performed during the evaluation including, pulmonary function testing, cardiac stress test, cardiac catheterization, CT scans and a chest X-ray.
Who is a Good Candidate for a Lung Transplant?
Most patients with severe end-stage lung diseases with a life expectancy projected to be less than two years can be considered for a lung transplant. In most cases, a successful lung transplant can provide years of quality life and can help make an individual’s breathing easier. A lung transplant is performed only after all other treatments for lung failure have been unsuccessful.
Patients are usually referred for a lung transplant evaluation by their pulmonologist; however, patients also have an opportunity to self-refer themselves for evaluation. Below are the guidelines to be considered as a candidate who may benefit from a lung transplant relating to the most common lung diseases.
- Idiopathic Pulmonary Fibrosis (IPF)/Interstitial Lung Disease (ILD) - A patient should be referred as soon as he or she is diagnosed with pulmonary fibrosis. This is a rapidly progressing disease and if a patient waits too long, there might not be enough time to complete an evaluation.
- Emphysema or Chronic Obstructive Pulmonary Disease (COPD) - The disease is progressive, despite maximal treatment, including medication, pulmonary rehabilitation and oxygen therapy.
- Pulmonary Hypertension - Advanced physical limitations despite being on maximal medical therapy.
- Sarcoidosis - Need for oxygen at rest and progressive decrease in lung function test.
- Cystic Fibrosis and Bronchiectasis - Clinical decline characterized by increasing fequency of exacerbations associated with any of the following: an episode of acute respiratory failure requiring non-invasive ventilation, increasing antibiotic resistance and poor clinical recovery from exacerbations, worsening nutritional status despite supplementation, pneumothorax and life-threatening hemoptysis despite bronchial embolization.
Lung Transplant Process, Risk and Recovery
Candidates are placed on the United Network of Organ Sharing (UNOS) list while awaiting transplant. Most patients will wait at home. During this time, the transplant team monitors the patient to ensure his or her condition remains stable. Once a donor lung is identified and thorough evaluations of both the donor organ and the patient have been performed, the lung transplant recipient will be called to the hospital to be admitted and prepared for his or her surgery.
Lung Transplant Risk
Lung transplantation is a major thoracic surgical procedure and can be accompanied by serious risks. Short-term risks may include:
- Donor organ dysfunction
- Hyperacute or acute rejection
- Renal failure
Long-term risks may include:
- Chronic rejection
- Peripheral neuropathy
- Hypertension (high blood pressure)
Specific risks and potential benefits of a lung transplant vary for each patient. Memorial Hermann-affiliated physicians will discuss the risks and benefits in detail with each patient and make every attempt to provide a successful outcome while minimizing the risks associated with the procedures.
After the Surgery
Recovery time after a lung transplant varies for each patient. Patients may stay in the hospital from two to three weeks, or longer. Some patients spend time in the intensive care unit (ICU) after surgery.
The recovery period usually lasts about three to six months, and includes frequent physician visits and regular tests, such as blood tests and bronchoscopies as well as participation in a pulmonary rehabilitation program.
For many patients, a lung transplant is a lifesaving procedure, opening the door to an improved quality of life and extended lifespan.
The survival rate for lung transplant patients has improved in recent years. According to the International Society of Heart and Lung Transplantation (ISHLT), the one year survival rate of lung transplant is around 80 percent and five year survival rate is more than 50 percent. Lung transplant survival rates have significantly increased in the past 20 years.
After recovery, most patients do not have limitations on their physical activities and are able to enjoy a good quality of life. However, fighting rejection is an ongoing process, and there may be other complications which may need treatment.
To find out more about lung transplantation, or to schedule an appointment with a physician affiliated with the Transplant Center, please call (713) 704-5200.
If you are a physician, and would like to refer a patient to the Transplant Center, click here.