What happens before surgery?
You will wait in the Transplant Unit until the transplant team has visualized the lung or lungs, and determined they are appropriate for transplant. While you are in the Transplant ICU, a complete physical, chest X-ray, blood tests, and an electrodardiogram (EKG) will be completed, and the results will be reviewed by your doctor.
If the donor lungs appear acceptable on direct visualization then you will be taken to the operating room within 1 to 2 hours. Your family can stay at your bedside until you are taken to the operating room.
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. You will meet a surgical team member who will consent you for the procedure.
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 This is termed a "dry run". You will be informed personally by a physician if your surgery is canceled due to a “dry run”. 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 medicine) 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 might 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 facility's 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.