How much do you know about lung transplantation?

Lung transplantation is also called “lung replacement”. When a person’s lungs suffer from severe disease that causes irreversible lung damage and the drug treatment is ineffective, it is called end-stage lung disease. The lungs are removed and healthy lungs are replaced at the same time, thereby restoring the patient’s normal breathing.

However, many people think that lung transplantation is the last treatment needed. In fact, they don’t know enough about lung transplantation.

The development of lung transplantation?

Lung transplantation is a highly difficult operation in the field of thoracic surgery and one of the top surgeries in thoracic surgery.
Lung transplantation can be traced back to animal experiments in the former Soviet Union in 1946. In 1963, the United States completed the world’s first human lung transplant. Since lung transplantation was accompanied by severe rejection, more than 40 lung transplants performed before the arrival of cyclosporine did not achieve long-term survival.

In 1983, Toronto, Canada, successfully completed a single lung transplantation of a pulmonary fibrosis patient and achieved a longer survival, which opened the door to modern lung transplantation. Lung transplantation requires the collaboration of professional multidisciplinary teams such as thoracic surgery, respiratory medicine, anesthesiology, critical care medicine, rehabilitation, etc. At present, with the continuous maturity of surgical anastomosis technology, the continuous progress of critical care medicine and the gradual improvement of immunological drug treatment, lung Transplant surgery is becoming mature.

Who needs a lung transplant?
Chronic obstructive pulmonary (COPD), pulmonary fibrosis, pulmonary hypertension, diffuse bronchiectasis… These diseases don’t sound serious, but once they progress to the terminal stage, the patient will have difficulty breathing, and some may even stay on the oxygen. The quality of life is very low when getting out of bed and walking. What’s more, if there is no ventilator assistance, they will not even survive a second, and a lung transplant is their last life-saving straw.

How difficult is the road to lung transplantation

Shortage of donors:
First, there is a severe shortage of donor lungs, and secondly, the requirements for donor maintenance before transplantation are relatively high. The ischemic time of lung transplantation is even shorter. The “preservation period” is only 6 hours, and the longest safe cold ischemia time of 12 hours cannot be exceeded, otherwise the quality will deteriorate and it may even be unusable. Longer ischemic time will lead to a decrease in the quality of the donor lung, which in turn affects the effect of lung transplantation. Therefore, lung transplantation is a life relay race against time.

Postoperative infection factors:

Different from other organ transplants, after liver, kidney and heart transplantation, these transplanted organs are internal organs, within the blood circulation and overall immune protection. After lung transplantation, the donor lung is directly connected to the atmosphere, and the external microorganisms and the microorganisms colonized by the donor lung itself increase the risk of infection of the transplanted lung. At the same time, the application of immunosuppressive agents also increases the risk of lung infection. , Including lung bacterial and fungal infections. Severe infections in a hypoimmune state after transplantation pose a huge threat to the lives of patients.

Postoperative rejection:

The human immune system protects the body from foreign substances. When the “new lung” is transplanted into the patient’s body, the patient’s immune system will use all the martial arts to try to attack and reject the transplanted “new lung”. The rejection of lung transplantation usually includes acute rejection and chronic rejection. Acute rejection will quickly get better after a series of anti-rejection drugs, while chronic rejection is lifelong and requires long-term anti-rejection drugs. Anti-rejection therapy after lung transplantation is a protracted battle for patients, and the evaluation and monitoring of lung transplant specialists will escort this long march of transplantation without gunpowder.

What is the overall effect of lung transplantation?

At present, lung transplant surgery technology is relatively mature, the total surgical success rate can reach more than 90%, and the 3-year and 5-year survival rates can reach 70% and 60%. With the update of anti-rejection drugs, there are more and more long-term survivors after lung transplantation.

The quality of life of patients after lung transplantation will be greatly improved. Say goodbye to the embarrassment of long-term bed oxygen and even ventilator assistance, life will return to normal track, and more and more patients will have normal childbirth after surgery and participate in marathon sports events.

The earlier the lung transplantation, the better the effect
Many patients in China choose lung transplantation with the mentality of a last stroke, not to improve the quality of life until they are very late. Therefore, most patients have to choose lung transplantation only when they are dying of end-stage lung disease, leading to miss the best time for lung transplantation.
The notion that domestic lung transplantation is life-saving has led to deviations in the prognosis of lung transplant patients in my country. In fact, the earlier the lung transplantation is done, the higher the survival rate and the better the quality of life. As long as the whole body is in good condition before transplantation, the success rate of the operation can reach 90%.