The most common indications for lung transplantation include obstructive (emphysema) and infection (fibrosis, bronchiectasis), lung disease, as well as primary pulmonary hypertension.
Lung transplantation is indicated for the progression of the disease and the ineffectiveness of other therapeutic measures. Transplantation of one lung can be performed from a donor diagnosed with brain death, and from a living donor. In living donor transplantation using the proportion of the lung, followed by implantation of the recipient.
In the case when replacing one light there is a great risk of infection of the graft through the remainder, carry out the transplantation of both lungs. The indications for heart-lung transplantation is a complex irreversible heart failure, which developed against the backdrop of severe pulmonary hypertension.
The patients' age, as a rule, should not exceed 60 years. Candidates for transplantation are patients who may die within 12-18 months. To determine the possible duration of life of these patients used indicators of respiratory function, exercise tolerance need for additional oxygen. Usually they kislorodozavisimy as the load and at rest.
The main contraindication for lung transplantation are cancers of other organs, a severe form of diabetes, renal and hepatic failure, HIV, mental illness.
Before surgery, patients undergo examinations, including conventional laboratory and functional studies, a detailed study of lung function and heart.
The complexity of donor support for the transplant lung is associated with a fairly common combination of head injury with damage to the chest and lungs. Compatibility of donor and recipient due to blood group and immunologic compatibility.
Technique removal of the lungs and their conservation is now standardized. Depending on the volume of transactions has its own technical features.
After surgery, the patient is transferred to the coronary care department., Prescribe antibiotics. Transplantation of one lung in the postoperative period the patient is laid on its side, and the operated lung is at the top. Locomotor activity is recommended to begin as early as possible. His features are available and the appointment of immunosuppressive therapy. It is administered 1-3 weeks after surgery.
Advances in lung transplantation shows promise in this direction in the treatment of end-stage of their disease.