Lung Transplant

Evaluation

First, a social evaluation determines if you have the psychological stability, motivation and personal support to meet the challenges of transplantation. 接下来，您将与专家团队会面他们将在整个移植过程中陪伴您. This team includes a pulmonologist (lung specialist), surgeon, nurse coordinator, social worker, psychologist and physical therapist.

• The transplant pulmonologist performs a physical exam, reviews your current medications, assesses the risks and benefits of transplant surgery, and makes recommendations to the team.
• The transplant surgeon performs a general surgical evaluation, 回顾你以前做过的手术，评估手术的风险和好处. 在与其他团队成员协商后，外科十大赌博平台排行榜提出移植建议.
• The thoracic surgeon who will perform the procedure performs a surgical consultation, discusses any abdominal or chest surgery you've had in the past, and goes over the plan for your surgery.
• 移植护士协调员负责组织移植前后的所有护理工作. The coordinator also provides patient education, coordinates testing and follow-up care, and maintains records.
• 保险协调人会审查你的保险，以确保你不会因为移植或手术后的护理而经历经济困难, and coordinates insurance coverage with outside case managers.
• 社工进行心理社会评估，并在整个过程中为你和你的家人提供支持. The social worker also advises the team regarding your psychosocial status, commitment to transplantation, and any financial issues. 社会工作者将与您会面，详细审查该计划，并可以帮助患者移植后的教育.
• Long-standing lung disease can strain the heart, so you'll also need to be evaluated by a cardiologist. The cardiologist will examine you and review your medical history and results from an electrocardiogram and echocardiogram. You may need to have an additional test with a procedure called cardiac catheterization. 该程序将由心脏科安排，可能需要在十大赌博平台排行榜过夜.
• 如果你患有囊性纤维化，你还需要去看耳鼻喉科专家. If you need minor sinus surgery, this will be arranged.
• If needed, 你将会见其他专家，他们将对你进行评估，并向移植团队提出建议. These may include an anesthesiologist, psychologist, infectious disease specialist, hematologist, intervention counselor and physical therapist.

Transplant candidates undergo a battery of tests that may include routine blood work, an electrocardiogram and other procedures. Once all the interviews and tests are completed, 移植团队回顾了所有的信息，并就如何治疗你的肺部疾病提出建议.

重要的是要记住，移植并不是适合所有肺部疾病患者的治疗方法. If you aren't accepted initially as a lung transplant candidate, 决定的原因以及其他测试和治疗方案将与您和您的转诊十大赌博平台排行榜讨论.

Waiting for a lung

Your new lung or lungs will come from a deceased person who is an organ donor. After being approved for transplantation, 患者立即被列入器官共享联合网络(UNOS)的等候名单. 你在等待名单上的位置取决于你病情的严重程度和移植成功的可能性, known as your lung allocation score. 当有合适的肺可用时，得分较高的人会获得更高的优先权. Compatibility is based primarily on body size and blood type.

During the waiting period, UCSF Medical Center provides a network of support for patients and family members, including a long-running, popular support group.

Preparation

在等待移植期间，十大赌博平台排行榜会定期检查你的情况. Your lung disease may cause issues that must be addressed, including:

• Shortness of breath and increased need for oxygen
• Decreased activity level
• Wasting of your muscle groups including respiratory muscles, postural or trunk muscles, and arm and leg muscles
• Cardiovascular deconditioning
• Fear or anxiety due to breathlessness

It's important to be in the best physical shape possible at the time of your surgery, so evaluation in a pulmonary rehabilitation program is essential. 移植前，你会被告知锻炼和活动的重要性, 包括训练你的呼吸肌，遵循自行车或步行计划的一般调节. You'll need to continue this program after your transplant.

We also require all patients to have an annual flu shot, a pneumonia vaccine, 最近10年内注射破伤风疫苗和b型流感嗜血杆菌疫苗.

Procedure

Once a donor is available, a transplant team removes the donor's lungs and brings them to UCSF Medical Center. While this is happening, you'll be notified to come to the hospital. This call may come at any time.

When the call comes, you'll first go to the Intensive Critical Care (ICC) Unit to prepare for surgery. Next, you'll be transferred to the operating room. 手术本身需要6到10个小时，具体时间取决于病人的身体状况.

If you're having a single lung transplant, the incision will be made on either your left or right side, about six inches below your armpit. 你的旧肺将通过这个开口被移除，新的肺将被植入. If you're receiving a double lung transplant, the incision will run across the lower part of your chest. The transplant lung or lungs will be connected to the pulmonary artery, pulmonary veins and a mainstem bronchus.

After surgery, you'll be taken back to the ICC Unit. 然后，根据你的情况，你会被转到心胸护理病房.

The typical hospital stay after an uncomplicated lung transplant is eight to 21 days. The incisions will be uncomfortable and take several weeks to heal.

After transplant, you'll follow a specialized rehabilitation program. 移植团队将在整个过程中以及在您的余生中陪伴您. You'll be seen as needed in the outpatient clinic. 移植专家每周7天，每天24小时为您提供问题或咨询.

Rejection and infection

Once your surgery is complete and the transplant is a technical success, the next stage is to live successfully with a transplant. This can become complicated. The two major issues are rejection and infection.

排斥反应是身体免疫系统将新肺识别为异物并试图摧毁它以保护你的自然过程. 这类似于你的身体将手指上的碎片识别为异物的方式, causing redness and inflammation in the area. To prevent rejection, you must be treated with immunosuppressants, medications that interfere with the body's normal immune response.

我们预计在移植后的前几个月你会有排异反应. To treat this, you'll receive immunosuppressant medications intravenously. Each patient is different, so you'll need frequent blood tests to determine the appropriate dose for you. The goal is to find the lowest effective dose that will prevent rejection, while minimizing the risk of infection and side effects from the medications. If you don't take these medications, your body will reject your new lung.

Because your immune system is suppressed, you'll be more prone to infection. We will monitor your temperature and white blood cell count for signs of infection. Infections are generally treated with antibiotics, 你会被要求定期服用某些药物来预防特定类型的感染. You may have to undergo intermittent short courses of intravenous antibiotics.

The signs of infection are redness, swelling and tenderness at a surgical site. 新的肺部感染可能以轻度发烧、新的咳嗽和肺部分泌物的变化开始.