The Lung Transplant Surgery and Recovery
Lung transplantation is a major procedure, but one that is routinely performed at Johns Hopkins.
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| Read about Stacy's experience after lung transplantation. |
All patients are brought into the operating room, a special endotracheal tube (breathing tube) and a transesophageal echocardiogram probe (an ultrasound tool used to monitor the heart) are placed. The incision is made horizontally between ribs and across the breast bone. When the new lungs arrive, the old lungs are removed one at a time, and replaced sequentially.
The majority of patients get two new lungs and have this done without the need for the heart lung bypass machine. During the surgery, there are several large tubes that are placed and brought out through the skin to drain the chest cavity.
Initial Recovery
As long as the new lungs are working, the patient is taken to the Cardiac Surgical Intensive Care Unit and the process to remove the breathing tube is begun. Within several hours and when the patient is stable an epidural catheter (a tube placed in the back) is placed to allow the team to give the patient pain control medication. This allows the area of the incision to be numb without the need for intravenous or oral narcotics that can make patients sleepy and cause constipation. Once the epidural is inserted, the patient's breathing tube is usually removed within 24 hours.
After the breathing tube is removed, the medical team guides the patient in a new phase of recovery. Patients are helped out of bed and they begin walking. They are given exercises to breathe and cough. Bronchoscopy is performed as needed to help keep the new airways clear. Within 48-72 hours patients are transferred to the recovery floor.
Long Term Recovery
On the recovery floor, day by day, tubes are removed and patients continue to walk and regain their strength. The transplant coordinators will begin teaching patients and the family about medications, what to expect at home, and assess their readiness for discharge from the hospital. Usually by 2-3 weeks patients are ready to go home. Occasionally patients require more physical therapy than can be provided at home and they may go to the inpatient rehabilitation unit at Johns Hopkins Hospital. While on that floor, the transplant team continues to see the patient and assists with their medical care.
