COPD and Lung Transplants
Lung transplants are often the final treatment option for people with severe chronic obstructive pulmonary disorder (COPD), offering increased life expectancy and higher quality of life for those with end stage COPD. However, lung transplants do not have the same rates of long-term success as other forms of transplant surgery and include a high occurrence of infection and rejection.
According to the International Society for Heart and Lung Transplant, a person must meet the following criteria to receive a lung transplant:
- the condition is worsening despite treatment
- enters a hypercapnic state (too much carbon dioxide in the blood)
- enters a hypoxemic state (too little oxygen in the blood)
- a forced expiratory volume in 1 second (the amount of air a person can force out of their lungs in 1 second) less than 25% lower than the value the doctor predicts would be had if the lungs were working normally
- Single lung, which involves a person receiving one lung.
- Double lung,
- Combined heart and lung, in which a person receives a heart and two lungs. This is generally only for people with either a congenital condition or a lung disease that has significantly damaged the heart.
A doctor may also consider placing a person on the lung transplant waiting list if they have a BODE index (Body-mass index, airflow Obstruction, Dyspnea, and Exercise) score of at least 80%, three or more severe COPD exacerbations in the past year, and/or moderate to severe pulmonary hypertension.
Short-term, the survival rates among lung transplant recipients are quite good – up to 92% of people survive for at least three months after the surgery. Research also suggests that lung transplants are the only intervention that can deliver long-term outcomes in people with very advanced cases of COPD, with roughly half of those receiving a lung transplant surviving for at least five years.
There are three types of lung transplant:
While there is currently no cure for COPD, for those with severe or end-stage COPD, lung transplantation offers a very real potential for improved quality of life.
Additional insight from Dr. Nair: When the doctor suggests undergoing a lung transplant evaluation, it is a scary proposition. But, as with all transplant surgery, it’s not something that happens immediately. It is a long and thorough process, and the wait for lungs is lengthy. The patient must also be extremely bad off, physically. A lung transplant is a lifelong commitment, but it can be miraculous.
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