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A Guide to Lung Transplantation

(Updated October 2005)

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What Is the Surgical Procedure?

A transplant operation will require many hours—about 1 hour to prepare you for anesthesia and to attach necessary monitoring lines, 4 to 8 hours of surgery for a single-lung transplant, and 6 to 12 hours for a double-lung transplant. Additional time may be required if you have had prior chest surgery.

Single-lung transplants are usually done through an incision made on the right or left side, depending on which lung is being replaced. Double-lung transplants are generally done using an incision across the entire chest, just below the breasts.

The operation begins when the donor lung arrives in the operating room. Your lung(s) is removed and the donor lung is placed in the chest cavity. The surgeon connects the blood vessels to and from the lung (pulmonary artery and pulmonary vein) and the main airway (bronchus) of the donor lung to your airway. The same connections are made for the other lung if you are having a double-lung transplant.

For a heart-lung transplant, you are connected to a heart-lung machine that circulates your blood while the operation is in progress. After both lungs and the heart are removed, the donor lungs are attached as described in the paragraph above. The donor heart is attached to a "cuff" of the old heart's atrium that was left in place for just that purpose, and the main artery (aorta) is attached to the aorta of the donor heart.

After surgery is completed, you will be taken to an intensive care unit (ICU) for postsurgical recovery and monitoring. You will be in the ICU for at least several days. While you are in the ICU, you will have a breathing tube and mechanical ventilation for 1 or 2 days, a nasogastric tube to remove stomach contents that might be aspirated or make you nauseous, chest tubes to drain blood and postsurgical fluids from the chest cavity, a Foley catheter to drain urine, and intravenous (IV) catheters in your neck and arm for monitoring and for providing necessary fluids and medications. After leaving the ICU, you will go to a hospital room. The average stay in a hospital varies between transplant programs but is generally 1 to 3 weeks. However, since many complications can occur, some people are in the ICU and in the hospital for much longer—sometimes many weeks or even months.

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