Lung transplants provide a cure in nearly any advanced, life-threatening lung disease, except cancer.
The most common indications for a lung transplant include
- pulmonary fibrosis
- chronic obstructive pulmonary disease (COPD)
- pulmonary vascular diseases and
- severe purulent lung infections (e.g. cystic fibrosis).
In Finland, all lung transplants including heart-lung transplants (cardiopulmonary transplants) are performed at HUCH. The first heart-lung transplant was completed in 1988 and the first lung transplant in 1990. Up until May 2012, 168 adult lung transplants and 35 heart-lung transplants had been completed at HUCH. Approximately 20 to 30 lung transplants are performed at HUCH every year, and the total amount has been increasing in recent years. Lung transplantation combined with corrective cardiac defect surgery has to a large extent replaced heart-lung transplantations.
In order to be considered for a lung transplant, patients must be compliant, co-operative and committed to lifelong medications and controls. Because finding a suitable transplant organ takes time, it is recommended that the tests preceding organ transplantation are taken according to an international schedule while the patient's condition is stable.
Lung transplantation surgery
Typically, both lungs are removed and replaced during lung transplantation. However, good results can be achieved by single-lung transplants when the patient has not suffered from lung infection.
Depending on their overall health, patients usually recover from a lung transplant operation in 2 to 3 weeks and can be discharged home or to a patient hotel. The active participation of a family member or close friend in the first stage of rehabilitation in Helsinki contributes to faster recovery and a more successful start to a new life.
As soon as the lungs start functioning normally, patients can resume their lives – younger patients can go back to school and adults can return to work. However, there are some restrictions on travelling to developing countries, for example, where there is little experience in the possible complications that organ transplant patients may face.
Rejection and long term results
After a transplant operation, patients are required to visit HUCH frequently for controls. In time, the frequency of these visits can be decreased, although an acute rejection reaction is possible throughout the patient's life. A rejection reaction is usually detected in routine lung function tests (e.g. breath tests) performed at home. When immediately addressed, an acute rejection reaction usually responds well to treatment.
Compared to other organ transplants, rejection reactions are more common in patients with lung transplants. To prevent transplant rejection, patients are required to take immunosuppressive drugs for the rest of their lives. However, the immunosuppressants also introduce some risks including an increased susceptibility to infections and the development of tumours or even cancer. Despite immunosuppressive therapy, chronic rejection occurs in approximately 50% of lung transplant patients, but typically not until several years after the operation. Chronic rejection can often be treated and the lung transplants continue to function for several years.
The long-term results of lung transplantations have improved rapidly in recent years and the current results from HUCH are high by international standards. Some 80% of the lung transplant patients operated on at HUCH in the 21st century are alive five years after surgery and more than 50% are likely to be well 10 years after surgery. The quality of life experienced by HUCH lung transplant patients corresponds closely with that of the general population.