Nowadays it’s so hard to surprise someoneorgan transplantation, that many will even find friends who have gone through this. In extreme cases, these will be the so-called “friends of friends”. I mean, such operations have become so commonplace that almost any organ can be transplanted. The main thing is to find the right donor and wait in line. Next is a matter of technology. Of course, there are a lot of people with problems now and not everyone will be able to get the coveted organ, but many do it. Someone's heart, someone's kidney, someone's liver, and someone's lungs. The process of lung transplantation is very complicated and the percentage of successful operations is lower than we would like. Let’s talk about this and understand generally how such operations are done.
- 1 What is lung transplantation
- 2 How do lung transplants
- 3 Who needs lung transplant surgery
- 4 Who should not be transplanted
- 5 When did the first lung transplant operation take place?
- 6 Statistics of lung transplant operations
- 7 How much does a lung transplant cost
- 8 Is a lung transplant required for patients with coronavirus
What is lung transplantation?
Lung transplantation is an operation thatmakes it possible to transplant a person's new lungs if something is wrong with his lungs. Speaking more scientifically, lung transplantation has the following definition.
Lung transplantation - surgery to completely or partially replace the affected lungs (illness, trauma, deviation) with healthy ones taken from a donor (another person)
Currently, only such a radicalintervention can make a person’s life better and longer if he has serious damage to this organ. At the same time, it is very complex and they resort to it only in the most extreme case, when there are no other chances for salvation.
The main limitation after such operations is that the patient has a long time, or even the rest of his life, take immunosuppressive drugs. Sometimes you have to actively use a mask with an oxygen cylinder, but usually it does not reach this point and after some time the patients return to a conditionally normal life.
How do lung transplants
Lung transplant operation is not much differentfrom any other transplant surgery. The main thing is that in it the whole team acted smoothly and very quickly. After the chest is opened by the surgeon, doctors do not have much time. The faster they do everything, the better.
Special it is important to sew up everything as quickly as possibleso that blood loss is minimal. And yet, since the operation is performed near the heart, everything must be done very carefully. Even though the heart stops during surgery, it still must not be damaged.
During lung transplant surgery it is important to do everything quickly and efficiently.
However, sometimes the lungs and heart change, if I may say so, comprehensively. There is even a special operation. Compatibility problems usually do not happen if the organs are taken from the same donor.
Such an operation is more complicated and longer, but sometimes it allows you to solve a whole range of problems, and not just those associated with lung diseases.
Who needs a lung transplant?
It is logical to assume that a transplant operation is needed for someone who is no longer helped by another treatment and needs some more serious intervention.
Among the main indications are diseases such as chronic obstructive pulmonary disease (COPD) and pulmonary emphysema. The majority of such cases is about a third.
Scientists have successfully cured a damaged lung. Donor organ deficiency will end?
There are other indications for transplantation,for example: idiopathic pulmonary fibrosis (20.8%); cystic fibrosis (15.9%); α1-antitrypsin deficiency (7.1%); primary pulmonary hypertension (3.3%). There are also other diseases, but there are too many of them and they account for the rest of the prescriptions for the operation.
The decision on transplantation is made every time.a group of doctors on the basis of how much the patient's quality of life has decreased (the necessary drugs, cylinders, lung ventilation). A prerequisite is that all medical treatment options should be exhausted.
Usually you have to wait for your donor so that everyonecoincided correctly. Sometimes the waiting period exceeds the patient's lifetime. In this case, the queue may move a little and patients who are in critical condition and cannot wait will receive organs earlier.
Who should not be transplanted
In addition to indications for a lung transplant, there is alsocontraindications. There are not many of them, but if they are, the patient will most likely be refused transplantation. However, there are exceptions. Cases with exceptions are called relative contraindications. When it is definitely impossible to do an operation - absolute.
Before surgery, you need to understand that the patient has no contraindications.
To absolute contraindications most ofteninclude cases when the patient can not take immunosuppressive drugs. When they can cause more serious diseases and in themselves lead to death.
For example, such absolute contraindications include:
- malignant tumors (now or transferred over the past 5 years)
- infectious diseases, primarily HIV / AIDS, hepatitis B and C
- acute or chronic diseases of other organs and systems of the body (heart failure, liver failure, etc.)
addiction, alcoholism, smoking
- psychological conditions that do not allow to achieve productive contact with a doctor
- mental illness
With relative contraindications, surgery is possible, but often it either simply does not make sense, or may carry risks that exceed average values for other patients. These include:
- over 65 years old
- low physical endurance, inability to perform simple physical exercises
- serious abnormalities of the body mass index
- damage to the respiratory tract by microbes or fungi that are immune to drugs.
In other cases, surgery is possible, but still, each time a decision is made individually based on the decision of the doctor or the medical board.
When did the first lung transplant operation take place?
Apart from artisanal operations and those that do notwere documented, it can be said that the first lung transplant operation was performed in 1946 by Vladimir Demikhov. The result of that operation was only that the operation is technically possible. It was carried out on a dog and the “patient” did not survive due to the organ being rejected.
The lungs were transplanted to a man for the first time on June 11, 1963. James Hardy from the University of Mississippi did this. True, the result can also be called only conditionally successful, since the patient died after two and a half weeks due to kidney failure.
For many more years, operations also failed andpatients died within a very short time after surgery. This happened until 1978, until the heart-lung machine and stronger drugs appeared that helped during the operation and the rehabilitation period.
Good question: Why does a person need air and how do lungs work?
Despite the fact that formally people survived untilof this, the first truly successful operation is considered a lung and heart transplant by Dr. Bruce Reitz from Stanford University in 1981. She was made into a woman with a serious pulmonary disease.
Lung transplant surgery statistics
As part of the World Health OrganizationThere is a structure that is responsible for accounting and conditional regulation of global transplantology. Someone calls it the International Society of Transplantation.
According to the statistics of this society, about3,000 transplant operations are easy. This is not as small as it could be, but significantly less than we would like, because many patients simply do not wait their turn.
There are statistics on the success of operations. According to her, five-year survival is more than 50 percent. This means that more than half of the people who have had the operation live after it for more than 5 years. The median survival is 5.4 years.
Median survival - this is how much half of the patients liveafter operation. Or how many half of patients have lived since a fatal illness. Not to be confused with the average period of life, which may differ. When calculating the life time after surgery, the calculation of the average value is not relevant, since everything greatly depends on the patient's age.
How much does a lung transplant cost
The price of a lung transplant is not entirely correctcount separately. Usually, an operation involves a whole complex of treatment, which consists of the preparatory process, medications, the operation itself, rehabilitation and other unplanned expenses.
If we talk specifically about the operation itself, then its cost varies greatly from country to country and on average is about 95,000 dollars.
Is a lung transplant required for patients with coronavirus?
Coronavirus itself cannot lead to disease,requiring a lung transplant. True, there is information that the virus, causing inflammatory processes, can permanently damage up to 20 percent of the lungs. Even if the disease is asymptomatic.
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Usually, even with such damage, it is not required.lung transplant. But some inflammation and developed pneumonia can lead to the need for such an operation. True, this probability is very low. At least for now. In general, there is a chance of dying from the effects of pneumonia, and more people die from them in the world than from myocardial infarction. Such deaths are not caused by pneumonia itself, but by septic shock, which affects other organs and systems.
In any case, do not be too relaxed about the likelihood of getting sick. Even without such extreme cases, the consequences can still be very serious. Therefore, just take care!