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Wednesday, October 1, 2014
Each hospital has different procedures in place for preparing a patient for lung transplant surgery. Listed below is the procedure followed by University Hospitals of Cleveland in Cleveland, Ohio. This information is meant to serve an example of what may happen in your hospital. Always talk with your doctor about what you can expect from their facility.
When an organ becomes available, your transplant coordinator will contact you and you must go to the hospital on very short notice. You should always have a family member ready to take you to the hospital when the time comes. Do not eat or drink anything after you are called.
Before your lung transplant surgery you will be admitted to the Intensive Care Unit.
An intravenous line will be placed in the neck to provide medication and a catheter will be put in your wrist to monitor blood pressure. These may be placed either before you go to the operating room or actually while you are in the operating room.
Your family can wait with you until you go into the operating room.
Once in the operating room the anesthesiologist and operating room nurses will keep you informed about the donor. In some cases, the donor organ that was initially considered for your transplant may, after final analysis, be inappropriate for transplantation. If that is the case, the surgeon will notify you as soon as it is known. Although disappointing, the decision is made with your best interest in mind.
If the donor organ is deemed acceptable, then you will be given a general anesthetic and the procedure will begin. Depending on your particular case; the surgeon will make an incision in the chest on one side, in the middle of the chest or under the bottom ribs on both sides to accommodate the transplanted lungs . Your lungs will be removed and your new lungs will be sewn into place and attached to your airways and pulmonary vessels. The surgery itself takes from around 4-8 hours.
When you wake up from anesthesia, you will be in the intensive care unit, where your condition will be monitored very carefully.
A breathing tube will likely be in place and you will be assisted by a ventilator. The breathing tube is usually removed when you're well enough to breathe on your own. This may be a variable amount of time but may occur as early as the first day after the transplant operation. When the tube is removed, you will be taught how to cough and deep breathe to keep your new lungs expanded and to help remove secretions.
The length of your stay depends on your recovery ability, which differs from person-to-person. The nurses will teach you how to self-administer any and all necessary care before you go home. The physical therapist will develop an exercise program to help you regain your stamina.
Two important factors while recovering are diet and exercise.
Excessive weight compromises your health by leading to increased blood pressure. One way to avoid excessive weight gain is to limit your intake of sugar, and replace it with fruits (which should be washed well!). Prednisone, a medication you may be on, also increase sodium retention, so you should monitor the salt-content of your diet.
Exercise and Activity
For the first 8 weeks, you should only do light activity, and not attempt to lift anything over 10 pounds. Avoid any activities that involve pushing or pulling heavy objects.
Your relationship with the transplant team is life long. If you are doing well and not having complications, you will probably only need to be seen 3 or 4 times a year after the first. Do not be complacent, the drugs you are taking need to be monitored continuously.
This information originally appeared in the University Hospitals Lung Transplantation Patient Handbook, and was adapted for use on NetWellness with permission, 2007.
Last Reviewed: Aug 27, 2013
Robert Schilz, DO, PhD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University