I thought I would write abit on Lung transplantation. There is alot of areas to cover of course but I thought I would cover the main bits and the parts people ask me about.
When a person with a lung disease gets to the stage in their health/life where they need to have a transplant they are referred by their current Dr to a transplant consultant. After all test results are sent over the transplant team arrange a pre assessment appointment. This is to meet the patient and look at their situation to see if they are suitable for the full assessment.
The proper assessment takes about 3 days and they do lots of tests (bloods, xrays, scans, walking tests, breathing tests etc). All aspects of the transplant are discussed to see whether its what the person wants and needs. They meet the consultant again, the surgeon, nurse to discuss aftercare (treatment, medication, and rejection etc) and the coordinators. After all of this the team will know whether or not transplant is the best way to go and usually will say by then. They have a meeting with all the team to discuss all aspects of the patient and make a final decision.
When the person has been accepted onto the list and all their blood results have returned then they will be "live" on the list. This list is uptodate and kept by the transplant team. There is no way of predicting how long they will be on the list and if they will get the transplant before they become too ill for it. There is no such thing as being at the top or bottom of the list, it all depends on a suitable match at the transplant unit. They have to match by blood type, size (height and weight), antibody tests, and tissue typing. Then of course the patients clinical condition has to be taken into consideration. If the patient is not well enough or has a temperature etc then that will affect the decision on the day.
For this reason at Papworth, people on the list have to keep in contact on a regular basis (every month) to give an update as such. Even if the health is exactly the same then they have to call to confirm that, but then of course if "poorly" or admitted to hospital then its also very important to keep the team aware of that. This is so that they know what state of health the patient is in and if they are well enough for transplant then they wont call anyone else as a backup for the organs like some transplant teams do.
People can wait a day, weeks, months, and of course even years. Then there are some that don't get the transplant at all and can die while on the list.
When waiting for the call its good to have a bag packed ready to go. The patient has to report to the transplant team if they go more then an hour away from home, and never keep their mobile to far away or off for that matter!
When/if the call happens then you cant eat or drink from that point. An ambulance car is sent to collect you and take you straight to the hospital at whichever speed they have been instructed. Then after going onto the ward (having been met by the transplant coordinator) bloods are taken amongst other tests to make sure all is ok. Then its just a case of waiting for the go ahead from the people who test the organs to see if they're suitable for transplant. Then if its a yes then straight to theatre and if not then back home to carry on waiting.
I was told at my assessment that transplant wont necessarily extend my life,but just make it a better quality. It could extend it but it all depends on the person and rejection factors etc.
Recovery in hospital can take up to a month if all goes to plan,firstly on intensive care and then on a ward. Immediately after the operation the patient is kept well sedated, attached to a ventilator to make them breath (also unable to talk), monitors, at least two chest drains, a catheter and various other lines for feeding, drugs and pain relief. These are gradually removed once the patient becomes stable. Sedation is gradually reduced allowing the patient to wake up and breath for themselves (also talk). Alot of people don't remember the time before then because of all the sedation and pain relief, but some can have vivid hallucinations which can be unpleasant.
During recovery the physiotherapists try to get patients up and about as soon as possible to maximise the function of the new lungs. This involves alot of exercise to help the return home easier.When this time comes then lots of medications are discussed, also about infections and of course forms of rejection and what to do if that happens.
In 2003 survival figures after one year for heart and lung transplant was 75% and survival after five years was 50%. Then the figures for lung transplant after one year was 80-85% then after five years was also 50%. Figures since then will of course vary,but these are the only ones i have!!
There's alot of stuff to cover about after transplant but I don't want to write about it till hopefully I experience it myself.
In my opinion if your not prepared to give an organ then you shouldn't expect to be given one.
