A double lung transplant, or bilateral lung transplant, involves the simultaneous surgical removal of two diseased lungs and replacing them with two healthy lungs from a matching donor. Many people that undergo a double lung transplant have cystic fibrosis, a disease that damages both lungs. Other conditions that can necessitate a double lung transplant are chronic obstructive pulmonary disease (COPD), emphysema, pulmonary hypertension, or pulmonary fibrosis.
Potential double lung transplant recipients are screened carefully before being placed on the waiting list for a transplant. The person must have a diagnosis of end-stage lung disease that has not responded to any other medications or treatments. The patient may not have other chronic medical conditions, any current infections, or an active cancer. Smoking, the use of alcohol, or using illegal drugs may disqualify someone from being approved for the transplant list. Other factors that may prevent someone from being added to the transplant list are severe psychiatric disorders and an advanced age.
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Donor lungs must match the recipient’s damaged lungs in both size and weight. The donor lungs are tested to match the recipient’s blood type, reducing the risk of antigens present that would cause a rejection response from the immune system. After the transplant is complete, the patient will need to take immunosuppressant drugs to prevent the body from attacking the new lungs like a foreign tissue. These medications must be taken daily for the remainder of their lifetime to prevent transplant rejection.
Symptoms of transplant rejection begin with fever, severe chest pain, and difficulty breathing. The person may also experience dizziness, chills, nausea, and night sweats. Anyone experiencing these symptoms post-transplant will need to be evaluated by a physician immediately. The immune system’s rejection of the donated lungs is a risk that will need to be continuously monitored with regular visits to the doctor. Doctors may need to prescribe antibiotics regularly to treat infections from a lowered immune response due to anti-rejection medications.
It is important that the transplant recipient have a strong family support system in place to help after the operation and during the recovery process. Healing from double lung transplant surgery usually requires a two to three week stay in the hospital. The first few days after surgery are spent in an intensive care unit (ICU), and vital signs are monitored closely. Following the hospital stay, a rehabilitation program of three to four months will begin. Generally, a lung transplant will need to be repeated every ten years.