|
Heart-and-lung transplant Description:
Heart-and-lung transplant operations have been performed since 1980 in the United States. The donated heart and lungs are from a human who has been declared brain-dead but remains on life-support. Tissue matches must be made to assure the patient's best chance of fighting off rejection of the transplanted tissue.
While the patient is deep asleep and pain-free (general anesthesia), an incision is made through the breast bone (sternum). Tubes are used to re-route the blood to a heart-lung bypass machine to keep the blood oxygenated and circulating during the surgery.
The patient's heart and lungs are removed and the donor heart and lungs are stitched into place.
Indications:
Heart-lung transplant may be recommended for patients with: Heart-and-lung transplants are not recommended for patients who have decreased kidney or liver function, insulin dependent diabetes mellitus , or other serious diseases.
What to Expect After:
Heart-and-lung transplant prolongs the life of a patient who otherwise would die. The operation is done only in patients where there is a very good chance of success. The long-term outcomes are unknown at this time.
As with all major organ transplants, the problems are finding a donor, fighting the rejection effect, and the cost of the surgery.
Finding a donor for heart-lung transplant can be difficult. The donated organs must come from a person who has been declared brain-dead but still on life-support while the patient is still in healthy-enough condition to survive the surgery.
Fighting rejection is an ongoing process. The body's immune system considers the transplanted organ as an invader (much like an infection) and fights it. To prevent rejection, organ transplant patients must take anti-rejection ( immunosuppression ) drugs (such as cyclosporine and corticosteroids) that reduce (suppress) the body's immune response and reduce the chance of rejection. These drugs also reduce the body's natural ability to fight off various infections.
Convalescence:
An extended hospital stay should be expected. The recovery period is about 6 months. Frequent check-ups with blood tests and X-ray tests will be necessary for years.
Risks:
Risks for any anesthesia are: Risks for any surgery are: Additional risks of transplant includes:
Cost:
The costs of any surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are younger, sicker, or need more extensive surgery will require more intensive and expensive treatment.
Heart-lung transplant surgery may exceed $250,000.
Surgery charges can be separated into five parts: 1) the surgeon's fee, 2) the anesthesiologist's fee, 3) the hospital charges, which includes nursing care and the operating room, 4) the medications, and 5) additional charges.
1. Surgeon's fee: variable
2. Anesthesiologist's fee: averages $350 to $400 per hour
3. Hospital charges: basic rate averages $1,500 to $1,800 per day (more for the intensive care unit (ICU) or private rooms)
4. Medication charges: $200 to $400
5. Additional charges: assisting surgeon, treatment of complications, diagnostic procedures (such as blood or X-ray exams), medical supplies, or equipment use.
Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.
Picture:
P0239.pctHeart, front view
P0359.pctLungs
P0240.pctHeart, section through the middle
This is a cross-sectional view of the interior of the heart. The valves, chambers, and associated vessels are labeled.
This is an illustration of the exterior of the heart. The arteries are colored blue and represent blood that is flowing into the heart. The veins are red and indicate blood flow out from the heart. The chambers are also labeled.
This is an illustration of the major features of the lungs and bronchial tree. The inset is of the alveoli. They are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
|
