Lung Transplantation Flashcards
For a single lung transplant, what is the incision used
Thoracotomy incision
What are 4 main diseases that lung transplantation has been successful in treating
Idiopathic pulmonary hypertension
Emphysema caused by alpha 1 anti-trypsin deficiency
idiopathic pulmonary fibrosis
Cystic fibrosis
What is the average waiting time to transplantation
18 months
What are 7 contraindications to lung transplantation
Hepatic disease Renal disease Aspergilloma Uncontrolled infection Malignancy inability to adhere to a complex treatment regime Poor nutritional status
Infection of what organism is cystic fibrosis is now a contraindication of lung transplantation
Burkholderia cenocepacia
What may occur in the first few days post-transplantation
re-implantation injury
What are post-operative surgical complications
Haemorrhage and dehiscence of the anastomosis
Why are prophylactic antibiotics given
To counter donor-acquired infection
What is needed to prevent rejection of the donor lungs
Immunosuppression
Combination of ciclosporin, azathioprine and corticosteroids
What might be given in the first few days to suppress T cell function
Anti-thymocyte globulin
What 2 things are patients at risk from after transplant
Rejection and infection
How does rejection and infection present
Malaise pyrexia infiltrates impaired oxygenation reduced lung function
What is the key investigation in identifying rejection of the donor lung and infection
Bronchoscopy with bronchoalveolar lavage and transbronchial biopsy
How are episodes of acute rejection treated
By intesification of immunosuppression
What is the most important complication threatening the long-term survival of patients after transplant?
Bronchiolitis obliterans syndrome
What does Bronchiolitis obliterans syndrome result from
chronic rejection of the donor lungs
What is Bronchiolitis obliterans syndrome characterised by
progressive airways obstruction as a result of obliteration of the bronchioles by organising fibrosis
What GI problem are transplant patients vulnerable to?
Reflux and gastric aspiration
What is the 1 year survival rate post lung transplantation
80%
What are the main two problems encountered when overcoming lung transplantation
Shortage of donor organs
Occurrence of obliterative bronchiolitis
What is involved in re-conditioning
The explanted organs are placed in a chamber connected to a heart by pass machine and then treated with nutrient rich solution to allow damaged cell to repair
What is the survival rate after transplantation at 5 years
55%
