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Median survival after BOS diagnosis is 3 to 5 years, whereas median survival after RAS diagnosis is limited to 0.5 to 1.5 years (5,6).
The most common long-term complication of lung transplant is chronic rejection. Chronic rejection is present in approximately half of all recipients within five years of the transplant.
Rejection is very common within the first six months following a lung transplant but can occur at any time, and patients should be educated that lifelong follow-up, testing, and treatment with anti-rejection medications are essential to carefully monitor for lung transplant complications.
There is a large variety of causes of death after lung transplantation with a dominant role of infection, CLAD and carcinoma. With increasing follow-up time, infection becomes less prevalent and CLAD and carcinoma are observed more frequently.
Because lungs are so fragile, life expectancy is shorter than with other solid organ transplants. Recovery from the surgery can take up to six months. But it can help you breathe better and improve your quality of life. However, you'll need to take immunosuppressants for the rest of your life.
Bacterial Infections
Pneumonias are the most significant bacterial infection in lung transplant recipients, and the highest risk is in the first 30 days post-transplant.
Even though medicines are used to suppress the immune system, organ transplants can still fail because of rejection. Single episodes of acute rejection rarely lead to organ failure. Chronic rejection is the leading cause of organ transplant failure. The organ slowly loses its function and symptoms start to appear.
Can you have a lung transplant more than once? Yes, this is possible, but not that common. Retransplantation accounts for about 4 percent of lung transplant procedures.
Lung transplants and life expectancy
It is estimated that 9 to 10 people survive a lung transplant. People can live for 5, 10, or even 20 years after having one. About 87 percent of CF patients who receive lung transplants will live another year.
Because of the fragility of the lung, the survival rates for lung transplant patients are not as good as for other solid organ transplants, with a five-year survival rate of about 50-60%. The biggest limiting factor in lung transplant is having enough suitable lung donors.
After lung transplant surgery, you'll remain in the intensive care unit for around 1 to 5 days. You will be given pain relief, which may include an epidural (a type of local anaesthetic) for pain relief and will be connected to a ventilator to help your breathing.
Lungs from donors with a chronological age of 45 and older can safely be transplanted, but the stakes may be higher for such allografts especially in combination with other extended donor criteria.
Patients who have a rejection score of three or four typically require treatment in the form of anti-rejection medication to trick the immune system into accepting the new lung. We usually begin with high doses of steroids that patients can take at home until the rejection reverses.
To allow the transplanted lung(s) to survive in your body, you will be given medications for the rest of your life to fight rejection. Each person may react differently to medications, and each transplant team has preferences for different medications.
For these reasons, long-term survival after a lung transplant is not as promising as it is after other organ transplants, like kidney or liver. Still, more than 80% of people survive at least one year after lung transplant. After three years, between 55% and 70% of those receiving lung transplants are alive.
Exclusion criteria for lung transplant
You may not be a good candidate if you have a body mass index (BMI) above 35. Before you can begin the lung transplant evaluation process, you must be free of: Cancer for at least 5 years. There are exceptions for certain types of cancers.
A single lung transplant may cost well over $929,600. A double lung transplant may cost well over $1,295,900. A lung transplant combined with another organ transplant, most commonly the heart, may cost well over $2,600,000. The majority of transplant costs are usually covered by public or private insurance.
Types of Organ Rejection
Acute rejection happens when your body's immune system treats the new organ like a foreign object and attacks it. We treat this by reducing your immune system's response with medication.
Treating rejection
Most rejection episodes can be reversed if detected and treated early. Treatment for rejection is determined by severity. The treatment may include giving you high doses of intravenous steroids called Solumedrol, changing the dosages of your anti-rejection medications, or adding new medications.
After your lung transplant—major surgery for which you prepared carefully—you'll likely enjoy a significantly improved quality of life. Most patients who have a transplant due to the effects of pulmonary fibrosis (PF) breathe better, increase their activity, and can discontinue supplemental oxygen.
Around 40 percent of lung transplant recipients will experience an episode of acute rejection within the first year. Some people may notice increased shortness of breath, cough, or a drop in their PFT's, but others may not have any symptoms of rejection.
Accordingly, survival after a lung transplant is higher in Australia than anywhere else. Regardless of the form of transplant (single lung, double lung or heart and double lung) the majority of patients (approximately 93%) will live at least a year or more following their transplant with 70% living 5 or more years.
Social and Emotional Adjustment After Transplantation
Having a lung transplant may cause fear, anxiety, and stress. After surgery, you may feel overwhelmed, depressed, or worried about complications. All of these feelings are normal for someone going through a major surgery.