A lung transplant is a surgical procedure to replace a diseased or failing lung with a healthy lung, usually from a deceased donor.
What are the indications of lung transplant?
A lung transplant is reserved for people who have tried other medications or treatments, but their conditions haven't sufficiently improved. Patients with Chronic Obstructive Pulmonary Disease, Idiopathic pulmonary fibrosis, cystic fibrosis and idiopathic pulmonary arterial hypertension are the patients who are likely to get a lung transplant.
Who cannot receive a lung transplant?
Patients with malignancies, active infections, other organ failures cannot receive a lung transplant.
Pre transplant procedures
Lung transplant involves lots of tests that need to be performed to confirm the health status of the patient. Also a lot of lifestyle modifications have to be made well in
advance of the transplantation. You should be always ready for the transplant as you never know when you will be called.
Lung transplant is performed under general anesthesia .An incision is made on the chest depending on the side in which the lung is transplanted. The failed lung/lungs are removed and the donor lung is transplanted and all the blood vessels and airways are connected.
After the transplant
You will be able to leave the hospital within two weeks. Immunosuppressants, the medication that prevents your body from rejecting the lung has to be taken daily without fail. You will have to strictly adhere to the diet, medications, lifestyle modifications and follow ups as prescribed to stay without complications.
Organ transplantation is one of the exceptional medical advances of the 20th century and it is the only way to treat patients with organ failure. The success rate of organ transplantation is continuing to improve due to advances in surgical techniques, advancement in immunosuppressive therapy, and advanced organ preserving methods.
Organs that are being successfully transplanted include kidneys, liver, pancreas, lungs, heart, and intestines. Tissues that transplanted include corneas, skin, heart valves, blood vessels, tendons, ligaments and nerves.
Common Types of Organ Transplants:
Kidney or renal transplantation is a surgical procedure where the damaged/failed kidney/end-stage renal disease is replaced with a living/deceased donor’s kidney.
Dialysis is also a mode of treatment for kidney failure; however, kidney transplant is believed to be a good treatment choice and offers more freedom and patients can lead a better quality of life. Any kidney patient of any age is eligible for a transplant but should be free of infection or cancer i.e. he/she should be a good candidate for transplant.
Post transplantation immunosuppressive medications or anti-rejection medicines are prescribed to protect the transplanted organ. Majority of patients can return to work in about eight weeks after the transplant.
All the recipients are recommended a healthy heart diet i.e. low-salt and low-fat diet and are recommended to have plenty of fluids.
Liver or hepatic transplantation is surgical replacement of damaged/diseased liver with a part of liver of a living donor or complete liver of a deceased donor.
A patient suffering from acute liver failure or chronic failure needs liver transplant. At this point in time, there is a no reliable device or machine that can perform all or vital functions of liver (like dialysis in case of kidney failure). Therefore, these patients require liver transplants.
Acute liver failure occurs when a healthy liver is injured massively by drug overdose, viral infections, ingestion of poisonous substances/food, or drug reaction. These patients are listed first in the transplant waiting list as there is a chance that they will die within few days if they are not transplanted.
Chronic liver failure occurs when there is repeated injury and repair where the hepatic tissue is replaced by scarred tissue leading to cirrhosis of liver i.e. irreversible damage needing a liver transplant. The reasons for chronic liver failure are viral infections, prolonged alcoholism, metabolic liver disease, autoimmune liver disorders and genetic liver diseases.
The outcomes of liver transplantation are good but vary depending on the indication for liver transplant. The current overall survival rate one after the liver transplant is estimated to be about 80% and the survival rate after five years of transplant is around 70%.
A heart or cardiac transplant is surgical replacement of a damaged heart with a healthy heart from a deceased donor. This procedure is usually performed on patients when there are no medical or surgical options left to treat due to end-stage heart failure or severe coronary heart disease.
Ventricular assist device and artificial hearts are often used as bridge to heart transplant in patients that are waiting for a heart transplant.
Transplanting or replacing a damaged pancreas with a healthy one is called pancreatic transplant.
More than 70% of the pancreatic transplantations are performed with kidney transplants i.e. both the organs are transplanted at once generally in patients who are severely diabetic and suffer from renal failure called simultaneous pancreas-kidney transplantation.
Islet cell transplantation is one of the new therapies that have shown some promising results but it is still in experimental and the efficacy of this treatment is not yet clinically proven.
Intestinal or small bowel transplant is a surgical replacement of diseased bowel or shortened small bowel with a healthy bowel from a donor.
A successful small bowel transplant will allow the patient to lead a normal life but the patient needs medication and has to undergo regular check-ups for the rest of life.
All patients needing a transplant can choose a hospital recognized by the respective state government cadaver transplant authority and register in the hospital of their choice. After registration, a panel of doctor will review your application and upon their approval, name of the patient is kept in a waiting list with a unique ID provided to each patient. The patients can check their status on the waiting list online.
The waiting time for transplant varies from patient to patient and the wait time can be longer due to shortage of organs. The organs are allocated or matched based on age, body size, health status, blood group, and tissue type.
Once a matching organ is available or allocated, the patient is informed by the hospital to reach the hospital as soon as possible. A battery of tests is performed to check if the patient is fit for transplant and if fit, transplant surgery is performed.
There are many patients that do not have a matching eligible living donor and in case of heart and lung transplant, the only way is to wait for a deceased donor.
Once a patient is deemed a transplant candidate, they can register with the respective state government’s cadaver transplant programs from the hospital of their choice.
Following is the list of some of the government bodies for your information.
Andhra Pradesh – Jeevandan
Kerala – Mrithasanjeevani
Karnataka – Jeevandsrthakathe (Transplant Authority of Karnataka)
Maharashtra – Zonal Transplant Coordination Committee (Mumbai, Pune & Nagpur)
Rajasthan – Navjeevan
Tamil Nadu – Cadaver Transplant Program (TRANSTAN)
Telangana – Jeevandan
Note: Registration happens in a transplant centre recognized by the cadaver transplant authority of state government and the waiting list is maintained by the concerned State’s cadaver transplant authority.
Intestinal transplant is a surgical procedure in which a patient’s failed or diseased part of intestine is replaced with the intestine from a donor.
What are the indications of intestinal transplant?
Short gut syndrome (68% of cases) and functional bowel problems (15%) are the major sources of intestinal failure leading to intestinal transplantation.
Who cannot receive a transplant?
Patients with active/untreated infections, malignancies and with severe cardiac or pulmonary diseases cannot have an intestinal transplant.
Pre transplant procedures
As part of the pre transplant work up you will have to get certain tests done and will have to consult some doctors to confirm that you are fit for the transplant. Cross matching will be done to ensure your body does not have any antibodies against the transplanted intestine. Your transplant will be postponed or cancelled if you develop any infection or disease prior to your transplant. So it is important to eat healthy and stay fit.
The surgery is performed under general anesthesia .The diseased part of intestine is removed through a midline incision on the abdomen. Later the blood vessels are
connected to the transplanted intestine. The surgery lasts for about 10 hours.
After the transplant
You will be able to leave the hospital within two or three weeks. Immunosuppressants, the medication that prevents your body from rejecting the
intestine has to be taken daily without fail. You will have to strictly adhere to the diet, medications and follow ups as prescribed to stay without complications.
A pancreas transplant is a surgical procedure to place a healthy pancreas from a donor into a person whose pancreas no longer functions properly.
What are the indications of pancreas transplant?
Pancreatic transplant is performed in a patient with Type I Diabetic Nephropathy. Usually pancreas transplant is performed simultaneously with kidney transplant.
Who cannot receive pancreas transplant?
Malignancy, active infection and other organ failures are contraindications for pancreatic transplantation.
Pre transplant procedures
As part of the pre transplant work up you will have to get certain tests done and will have to consult some doctors to confirm that you are fit for the transplant. Cross matching will be done to ensure your body does not have any antibodies against the new pancreas. Your transplant will be postponed or cancelled if you develop any infection or disease prior to your transplant. So it is important to eat healthy and stay fit.
The surgery is performed under general anesthesia .The patient’s pancreas is generally not removed from the body. The new pancreas is placed on the right lower part of the person’s An incision is made under the ribs and the diseased liver is removed. Later the donor liver is transplanted and the blood vessels are connected. The surgery lasts for 6-12 hours.
After the transplant
You will be able to leave the hospital within two or three weeks. Immunosuppressants, the medication that prevents your body from rejecting the new liver has to be taken daily without fail. You will have to strictly adhere to the diet, medications and follow ups as prescribed to stay without complications.