The Surgery

Transplantation

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Lung Transplant Surgery

During a lung transplant patients may receive a single lung (unilateral transplant) or two lungs (bilateral transplant), depending on their disease. In patients with chronic lung infections such as cystic fibrosis or severe pulmonary hypertension both lungs will be transplanted. If the lungs are damaged but not infected, which may be the case in patients with emphysema, surgeons often leave the less damaged lung in place.

Procuring the Donor Lung

When a compatible donor organ becomes available the lung(s) must be transplanted into the recipient within about six to eight hours after procurement. Members of the transplant team personally travel to the organ donor's hospital to ensure that the lung(s) are suitable for transplantation prior to surgery. If the donor lung(s) is damaged, infected, traumatized, or has other problems the transplant surgery will be canceled.

While the donor lungs are being examined the patient simultaneously undergoes a variety of pre-surgical tests and is prepared for surgery.

The Operation

If both the donor lung(s) and recipient are cleared for surgery, the transplant team:

puts the patient under general anesthesia
makes an incision in his or her chest
removes the patient's damaged lung(s)
places the donor lungs in the chest cavity
connects the pulmonary artery, vein, and bronchus to the new lungs
and inserts drainage tubes to help drain air, fluid, and blood out of the chest while the new lungs re-expand

Surgery may take four to eight hours, depending on whether it is a single or double transplant, and if any complications occur.

Most lung transplant surgeries are now performed without using the heart-lung bypass machine, sparing patients from post-operative complications associated with use of the machine. Surgical techniques have also recently advanced so that surgeons at the Center can now make a smaller incision during transplantation.