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Lung transplantation is the surgery performed to replace the diseased lung or lungs with a new and healthy lung donated by a donor. The donor is usually on the life support after the brain dead and under the age of 65. The tissue of the donor must be matching close to the type of the tissue of the patient, to ensure the new lung is not rejected. Lungs can also be donated by the living donors, where two or more donors donate each lobe or segment of the lung, so that the entire lung is formed.
Lung transplant is recommended by the transplant team, only after the all other treatments are failed for the lung diseases. It is recommended only for under the age of 65, who have been suffering from severe lung diseases.
The lung diseases that may lead to the lung transplant are, * Sarcoidosis * Cystic fibrosis * Lung arteries damaged caused from heart defect right from the birth * Chronic Obstructive Pulmonary Disease or COPD * Emphysema * Swollen and scarred lung tissue conditions, like interstitial lung disease * High blood pressure experienced by the lungs arteries or pulmonary hypertension * Bronchiectasis or destruction of the lung and large airways
However, lung transplant is not done for the following patients. * Badly nourished * Too sick * Smoke abused * Alcohol or drug abused * Active hepatitis B * Active hepatitis C * Active HIV * Cancer before 2 years * Lung disease that may affect the transplanted lung * Severe disease associated with other organsConverting the food to energy Regulation of the blood clot Forming the bile and then production of proteins used for blood plasma Clear of the blood from poisonous substances like drugs
Before deciding for the lung transplant, the transplant team needs these tests to be done. * Check for infections through skin and blood tests *Blood typing * Tests to lung evaluation * Tests for early cancer * Tests for heart evaluation through cardiac catheterization, EKG or echo cardiogram * Tissue typing to ensure the new lung is not rejectedBiliary Atresia – This condition occurs from either absence of the bile ducts or abnormal development of the same. Acute Hepatic Necrosis – This condition is caused because the tissue in the liver dies. Liver Cancers – Primary tumors in the liver, and not yet spread to the external parts of the liver. Metabolic Disease – This is a condition, caused from the chemical activity, caused by the liver in the cells. Autoimmune Hepatitis – Damage and destruction of the liver because of the chronic inflammation caused in the liver.
* The patient is given general anesthesia so that the patient feels no pains and gets asleep. * A small cut is made over the chest. A heart lung machine is employed during the surgery to function the work of the heart, while the heart is stopped its function, during the surgery. * For lung transplant, * When a single lung transplant is done, a small cut is made aside the chest. The transplant procedure takes around 4 to 8 hours of time. Usually, the lung that has worst function will be removed. * When a double lung transplant is done, the surgical cut is made at lower part or below of the breast, so that either sides of the chest is reached. This surgery needs 6 to 12 hours of time. Then the tubes are sent to enable the flow of the oxygenated blood through the heart lung bypass machine and make free movement of the blood throughout the body. * After the surgical cut is made, one or two of the lungs are removed from the body. When double transplantation is done, first transplant is completed and then the second one is started. * The airway and main blood vessels of the lung that is transplanted will be sewn to the airway and blood vessels. The donor’s lobe or lungs will be sutured or stitched in its place. Blood, air and fluid are drained out through chest tubes out from the chest and it is continued until the lungs are re-expanded to full extent.
In case the heart is also diseased, both the lung and heart transplants are done during the same transplant surgery.Blood vessels blocked in the newly transplanted liver Infection Block of bile duct Bile Leakage No function of the new liver.
Stay is expected to be 7 to 21 days after the surgery in the hospital. Recovery period to get back to regular and normal activities is 6 months. Regular checkups, x-rays and blood tests are to be followed for years after the surgery.Treatment regimen noncompliance Serious liver disease persisting, even after the transplantation Other medical conditions, like sever cardiac problem, which could not tolerate the hard surgical procedure Difficult treatment of current or recurring infection Alcohol consumption Metastatic cancer, spread around the source location
Risks associated with the lung transplant are, * Blood clot *Bone thinning * Diabetes * Risk of infections * Risk of cancer in the future * Rejection of the transplanted lung * Damage to the other organsUrgency – based on the critical condition of the patient Diagnostic Tests – to assess the liver and overall status of health of the patient. Psychological and social evaluation – it includes assessing the stress, family support, financial condition, etc., which influence the final outcome of the transplantation. Blood Tests – to assess matching potential of the donor liver with the liver of the patient
The above Package Cost is a tentative Approximate Package Estimate, which includes initial investigations & specialists screening, stay in a Private Room wherein patient’s assistant or relative can also stay with patient, doctor / surgeon fee, nursing care, medicines & consumables, Airport Pick-Up & Drop.You have to wear a gown after removing your cloths It starts with IV or intravenous line on the hand. Heart and blood pressure monitoring catheter are inserted to the wrist and neck. Additional catheters may be inserted at subclavian areas. You need to lye on the table. Excessive hair is removed at the site of surgery A catheter is arranged to drain urine After sedation, a tube is inserted into the lungs to control breathing through a ventilator. Skin is cleaned using an antiseptic solution A slant incision is done under the ribs. The diseased liver is separated from the structure and surrounding organs to remove and the veins and arteries are clamped to control the flow of blood to the liver Donor liver is taken and connected to the blood vessels of the patient, and blood flow is established. Bile ducts are connected Incision is closed Drain may be needed to place in the site of incision to control swelling Dressing is done
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