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WHAT YOU NEED TO KNOW:
A lung transplant is surgery to replace your lung with a donor lung. Lung transplant surgery may be performed on one or both lungs. If you have severe heart disease, you may have heart and lung transplant surgery at the same time. Ask for more information about a heart and lung transplant.
HOW TO PREPARE:
Before your surgery:
While you wait for your donor lung:
- Meet with your transplant team and other specialists: Your transplant team will explain the risks and benefits of a lung transplant. You may visit with a social worker or psychologist. This person will make sure that you are mentally and emotionally prepared for a transplant. A dietitian may help you with meal planning and healthy eating. You may also meet with a cardiologist and pulmonologist. You must agree to follow the instructions given to you by these specialists. You must also agree to take antirejection medicines for the rest of your life after the transplant.
- Stay close to the transplant center: You must be prepared to go to the transplant center right away if a donor lung becomes available. You may have to live within a 2-hour drive of your transplant center.
- Work on lung rehabilitation: You will need to improve your lung function and decrease shortness of breath before a transplant. You will need tests to find out how strong and physically fit you are. Other tests will show how much oxygen you need at rest and during physical activity. You will work with a physical therapist to improve your muscle strength, flexibility, and exercise endurance before a transplant.
- Do not smoke: No smoking before, during, or after the time period surrounding your transplant. Do not start again after the transplant. You will not be given a donor lung if you smoke cigarettes while you wait for a lung to become available.
- Maintain a healthy weight: You may not be given a donor lung if you are overweight. This is because obesity raises the risk for life-threatening complications after a transplant. Ask your transplant team if you need help with a weight-loss plan.
- Get tests ordered by your transplant center: You need many tests to make sure your body is healthy enough for a transplant. These tests include a chest x-ray, electrocardiogram, CT scan, pulmonary function tests, and blood tests. You may need these tests more than once. You may also need a barium swallow test to find out how well you can swallow. This is important because a lung transplant can cause nerve damage and swallowing problems. Ask your healthcare provider for information about these and other tests you may need.
- Get vaccines: If you have immunization records, show them to your transplant team. You may need vaccines or booster shots to prevent pneumonia, tetanus, hepatitis B, influenza, and other infections. It is important to get these vaccines now because you will be at high risk for infection after your transplant.
Prepare for surgery:
- Bring your medicine bottles or a list of your medicines when you see your healthcare provider. Tell your provider if you are allergic to any medicine. Tell your provider if you use any herbs, food supplements, or over-the-counter medicine.
- Ask your healthcare provider if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
The day of your surgery:
- You or a close family member will be asked to sign a legal document called a consent form. It gives healthcare providers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
- Healthcare providers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- Arterial line or pulmonary artery catheter: An arterial line is a tube that is placed into an artery, usually in the wrist or groin. It is used to monitor your blood pressure continuously or to take blood. A pulmonary artery catheter is a tube inserted through a vein into your heart and the arteries leading to your lungs. It is used to monitor blood flow through your heart during and after surgery.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell healthcare providers if you or anyone in your family has had a problem with anesthesia in the past.
WHAT WILL HAPPEN:
What will happen:
- You will be given anesthesia to keep you asleep and free from pain during your surgery. Your surgeon will make 1 or 2 incisions that begin at your armpit and go to or across your chest. He will remove your failing lung and place the donor lung into your chest. The donor lung will be stitched to your airway and to the blood vessels in your heart. If you are having a double-lung transplant, your weakest lung will be removed and replaced first. An endotracheal (ET) may be inserted into one lung while the other lung is removed and replaced. The ET tube is hooked to a ventilator to help you breathe. You may also need cardiopulmonary bypass during surgery. This is when a machine pumps blood and provides oxygen in place of your heart and lungs.
- Your surgeon will insert a thin tube called a bronchoscope down your throat and into your airway. A light and camera on the bronchoscope allows him to check the incisions and stitches inside your airway. You will have 2 or 3 tubes inserted in each incision to drain fluid and air. Your incisions will be closed with stitches and covered with bandages.
After your surgery:
- You will be taken to the intensive care unit where you will rest and be monitored. A healthcare provider will check your blood pressure, breathing, heart rate, and temperature often after your surgery. You may be given medicine to keep you asleep and comfortable for a period of time after surgery. You will have an endotracheal (ET) tube in your mouth and throat. The ET tube is connected to a ventilator that helps you breathe. The ET tube will be removed when you can breathe well on your own.
- You will have many tubes in place when you wake up. The tubes will cause discomfort and make it hard for you to move, but they help healthcare providers monitor your condition. Do not get out of bed until a healthcare provider says it is okay and is there to help you. Healthcare providers will check your wound often for signs of infection. Healthcare providers will also give you pain medicine.
CONTACT YOUR HEALTHCARE PROVIDER IF:
- You have a fever.
- You have questions or concerns about your surgery.
Seek Care Immediately if
- You have new or worse shortness of breath.
- You have chest pain.
- You may lose more blood during surgery than expected and need a blood transfusion. You could get a life-threatening blood clot. You could get an infection in your lungs or in your incision. Fluid could collect in your lungs or around your heart. Your donor lung could be damaged before or during surgery. Your heartbeat could be irregular for a while after surgery. Your stitches could break open, and you may need another surgery to fix them.
- You could have nerve damage that makes it hard for you to cough and clear the fluid from your airway. Nerve damage also increases the risk that you will have trouble swallowing, or develop gastroesophageal reflux or infections after your transplant. Your new lung may not function properly. You may need another transplant. If you have a single-lung transplant, the non-transplanted lung could collapse or develop an infection or cancer.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.
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