Preparing for Lung Transplant Surgery
Getting the call
When a lung has been identified for you, a transplant coordinator will contact you by telephone or pager. Remember, this could be any time of the day or night.
As soon as you receive the call, do not eat or drink anything (not even water). Your stomach must be empty before surgery.
It is normal to feel both excited and scared. Because of the natural confusion caused by the need to get to the hospital quickly, you might feel rushed and confused. You'll be glad you planned ahead to get to the hospital with minimal delay, knowing you have left your home in order.
Getting to the hospital
As soon as you receive the call, bring your suitcase that you've packed ahead of time and go directly to the hospital. Even though the donor lung receives special handling, there is a time limit.
If you live more than 1-1/2 hours away from the transplant center, the transplant coordinator on call will arrange transportation for you and one family member. If you live less than 1-1/2 hours away, you must have someone drive you quickly, but carefully, to the hospital.
What happens before surgery?
You will wait in the Transplant Unit until the final results of the crossmatch are determined. If the crossmatch results are negative (or compatible) and the on-site organ procurement team indicates the organ is of good quality, you will be prepared for surgery (generally within a few hours of your admission).
Just before surgery, you will be asked questions and undergo tests to make sure you are in the best possible physical and emotional condition for the transplant.
If you have a cold, sore throat, fever, or any type of infection, it is very important to tell the nursing staff. It is also very important to tell the staff about any other problems you may have.
A complete physical, chest X-ray, blood tests, and an electrocardiogram (EKG) will be completed, and the results will be reviewed by your doctor.
If you have a significant medical problem or any signs of infection, or if the donor lung is determined to be unacceptable, the surgery will be canceled. It is better to wait until another lung becomes available than to risk a transplant under these circumstances.
Before you go to the operating room, you will be asked to:
- Wear a hospital gown
- Empty your bladder
- Remove your dentures or partial plate
- Remove your eyeglasses or contact lenses
- Remove jewelry, makeup, nail polish, and hair pins
If you had previously consented to participate in a clinical trial, the trial information will be discussed again with you.
To prepare you for the transplant surgery, the incision area will be shaved (from your chest to your knees) to prevent infection. You will also have an intravenous tube (IV) inserted in your arm to deliver fluids and medicine. Before going to the operating room, you will be given a sedative to help you relax and make you sleepy.
What happens during surgery?
An anesthesiologist will inject general anesthesia (pain-relieving medication) through your IV, which will make you go to sleep. After you are asleep:
- A central venous catheter is inserted into a vein in your neck or groin. This type of catheter is used to deliver fluids, nutrition solutions, antibiotics, or blood products directly into your bloodstream without frequently having to insert a needle into your vein.
- A tube is placed in your mouth that goes down your throat and into your windpipe (trachea) to help you breathe. The tube is attached to a ventilator that will expand your lungs mechanically.
- You may be placed on a heart/lung machine to allow surgeons to bypass the blood flow to the heart and lungs. The machine pumps blood through the body, removing carbon dioxide (a waste product) and replacing it with oxygen needed by body tissues.
- A nasogastric tube is inserted through your nose into your stomach. This tube drains secretions from your stomach.
- A tube called a catheter is placed in your bladder to drain urine.
- The surgeon carefully removes your lung and replaces it with the donor lung.
How long does the surgery last?
The procedure lasts about 6 hours. Family members and friends are invited to wait for you in the Family Waiting Lounge until the surgery is completed. We ask visitors to sign in and out of the waiting area and provide a phone number so we can contact them if necessary. A member of the transplant team will meet with your family in the waiting area to keep them updated on the progress of your surgery. Your family will be notified when the surgery is complete and when they can visit you in the intensive care unit.
What are the risks of the transplant?
Where will I receive care after transplant surgery?
Lung transplantation is a complex process and there are many risks that accompany the procedure. The transplant team will discuss the potential risks and possible benefits of the procedure with you. Please ask questions to make sure you understand the potential risks and benefits. (lung transplant rejection)
After your surgery, you will receive care in the Intensive Care Unit (ICU) and then in the Transplant Unit. This unit is designated for all transplant patients. The staff in the Transplant Unit is experienced in meeting the unique needs of lung transplant patients and their families.