- Ex Vivo Lung Perfusion Treatment to Increase Number of Suitable Donor Lungs for Transplant Recipients
The goal of ex vivo lung perfusion is to help make a greater number of donor lungs more suitable for transplant recipients. This ground-breaking treatment is now available at Loyola Medicine for select recipients.
Lung Transplant Surgery
Overview and Facts about Lung Transplant Surgery
Exceptional Care and Advanced Surgical Techniques for Lung Transplant
Loyola Medicine provides comprehensive, multidisciplinary care for patients with advanced lung disease whose best medical option is a lung transplant. For patients whose pulmonologist has recommended a lung transplant, Loyola’s transplant surgeons are compassionate and highly skilled in performing life-saving lung transplant surgery.
Lung transplant surgery removes one or both damaged or diseased lungs and replaces them with healthy donor lungs. Qualifying for a lung transplant is an extensive process and includes a detailed evaluation, a search for donor lungs, the transplant surgery and a recovery period.
We understand that if you are considering a lung transplant, you have endured much because of your condition and want your life to return to normal. Loyola’s expert transplant team will provide compassionate care and the most advanced treatment options available.
Loyola is participating in a clinical trial to increase the number of donor lungs suitable for transplant. This innovative technique is called ex vivo lung perfusion (EVLP).
Why Choose Loyola for Lung Transplant Surgery?
Loyola’s Transplant Center, which has performed more than 825 lung or heart-lung transplants since 1988, has the medical expertise and technological resources to care for the most difficult respiratory system conditions—whether you need a heart-lung, double-lung or single-lung transplant. Loyola’s pulmonary transplant program provides a full range of services for advanced lung disease patients of all ages as they prepare for a lung or multi-organ transplant.
According to the International Society for Heart & Lung Transplantation, Loyola’s lung transplant program is among the top 15 percent in the world with regard to volume, which leads to better outcomes. Our one-month and three-year patient survival rates are better than the national average, as are our one-month and three-year graft survival rates.
Loyola does a superb job helping our patients survive the rigors of transplant surgery. Our mortality rate is now 0 percent, as opposed to the national rate of 5.9 percent. Loyola is the only center in the United States to seamlessly perform five lung transplants in the span of a day, showing the dedication, drive and talent of our team. We have a reputation for treating the most acute cases of lung disease, and our youngest lung transplant patient was 15 years old.
As a world-class academic medical center, our doctors perform and teach the latest surgical techniques and exceptional medical care. Loyola’s skilled and compassionate nurse coordinators work closely with transplant patients, providing support and answering your questions—not only before surgery, but afterward as well.
What are the Different Types of Lung Transplants?
Lung transplant patients can benefit from three kinds of transplants:
- Single-lung transplant — One diseased or damaged lung is removed and replaced with a healthy donated lung. This surgery is beneficial for patients with pulmonary fibrosis, among other diseases. However, it is not used as a treatment for patients with cystic fibrosis, because the condition will spread from the diseased lung to the donated lung.
- Double-lung transplant — Both damaged or diseased lungs are removed and replaced with a healthy set of donated lungs. This is considered the optimal treatment for patients with cystic fibrosis and chronic obstructive pulmonary disease (COPD).
- Heart-lung transplant — The damaged or diseased heart and lungs are removed and replaced with a healthy donated heart and a set of lungs. This is often the recommended therapy for people with severe pulmonary hypertension.
With the goal of bringing life-saving lung transplant surgery to more patients, Loyola is participating in a clinical trial to increase the number of donor lungs suitable for transplant. This innovative technique is called ex vivo lung perfusion (EVLP).
What to Expect
What to Expect with Lung Transplant Surgery
Once a lung or multi-organ donation becomes available, your medical team will quickly make the arrangements for your surgery and hospital stay. Your nurse coordinator will inform you and your family about where to go.
Time is of the essence, and you will be expected to leave for the hospital shortly after receiving the call that a heart-lung, single-lung or double-lung transplant is available. The lung or lungs must be transplanted within six to eight hours after becoming available. As you will be instructed during your education classes, the transplant surgery may be canceled if your transplant surgeon considers the donor lung or lungs damaged or otherwise in poor condition.
After you arrive, you will undergo a few final tests for infection, fever and other conditions. In the operating room you will receive general anesthesia and be set up for an IV. You also will be put on a Foley catheter to manage urine production. Most lung transplant surgeries are completed without the use of the heart-lung bypass machine, which can spare post-transplant patients from certain complications. Lung transplant surgery usually lasts four to six hours.
During the surgery, your surgeon will remove the diseased lung or lungs and position the donated tissue. Your surgeon will connect the pulmonary artery, pulmonary vein and the airway of the donor lung or lungs to your blood vessels and airway. Tubes to drain fluid, blood and air will be inserted and will remain for several days after surgery.
What are the Risks of Lung Transplant Surgery?
Whether you have suffered from chronic obstructive pulmonary disease (COPD), cystic fibrosis or primary pulmonary hypertension, surgery may be the best treatment for your condition. With any surgery there are risks; in the case of lung transplant surgery, these may include:
Ongoing Support and Treatment after Lung Transplant Surgery
Your Loyola transplant doctors and nurses will monitor you very closely after surgery. Physical therapists will work with you to help you get up and walking. You will have a catheter as you recover from transplant surgery. Most recipients go home on average about 15 days after surgery, but each patient’s case is unique. We encourage you to participate in our support group, which will help as you recover.
Our medical staff will send you home with medication. Before your surgery, you will be given a strict schedule for your immunosuppressive medication, which is very important to follow. You will need to take these medications for the rest of your life to prevent your body from rejecting the donated tissue. These medications work by lowering your body’s immune response to the new tissue, but this will make you more vulnerable to infection, especially in the first three to six months. Call your nurse coordinator right away if you develop these signs of organ rejection:
- Chest pain
- Feeling like you have the flu
- Shortness of breath
You will be instructed not to lift anything heavy after surgery until your pulmonologist gives you clearance. After your discharge from the hospital, you should walk every day and stay active. You should also follow your nutrition plan as your body will have extra requirements as you heal. If you are from out of town, you will be asked to remain in the area for at least two months as your pulmonologist adjusts your medications and monitors you for signs of lung rejection.
Lung recipients are followed quite closely during the first year after surgery with frequent labs, pulmonary function tests and clinic visits to help identify any signs of rejection. Loyola’s lung support group offers education and support—not only before transplant surgery, but also afterward. We encourage you and your family to join and benefit from these services.
After you are discharged, you will have weekly doctor visits and lab work twice a week, as well as chest X-rays. You also will have regular fiberoptic bronchoscopies to check your upper respiratory tract. During this procedure, you will be sedated and your doctor will use a thin bronchoscope to check your air passages and, if necessary, take samples of tissue and fluid. You should be able to return to work or school within three to six months of your surgery.
Eventually, visits with your pulmonologist will become less frequent and your care team will start to integrate your primary care doctor in your care. However, your transplant care team is your partner for life and is available around the clock should you have a question or concern. Please call us at 708-327-5864 or 800-424-6313.
To learn more, read our lung transplant frequently asked questions.