Lung Transplant for Patients with Pulmonary Hypertension
While progress has been made in the treatment of pulmonary hypertension (PH), unfortunately there is still no cure for this disease.
When PH worsens, despite medical therapy, one treatment option to consider is lung transplantation.
At the UPMC Comprehensive Pulmonary Hypertension Program, we often will discuss the idea of lung transplant early with patients, even if it may not be necessary for some time.
Our pulmonologists work with experts in the UPMC Lung Transplant Program, who have been performing transplants since 1988. Our lung transplant survival statistics in patients with PH are better than the national average.
In addition, we are one of the few centers to transplant a large number of patients with scleroderma-associated pulmonary hypertension, and have demonstrated good outcomes.
Potential Risks of Lung Transplant Surgery for Pulmonary Hypertension Patients
We emphasize to patients that lung transplant surgery brings with it potential risks as well as benefits.
Surgical risks include (but are not limited to):
- Failure to wean from the ventilator and failure to wean from oxygen
Pulmonary Hypertension Candidates for Lung Transplant Surgery
Because of the risks of this procedure, patients must undergo a thorough evaluation to make sure they are good candidates for lung transplant. The evaluation process is typically a one-week period of outpatient testing and clinic visits.
After collecting all of the data, the lung transplant team discusses each patient’s case of pulmonary hypertension. At this meeting, the team decides to recommend putting the patient on the transplant list or gather more data if necessary.
Patients and referring physicians are notified of all decisions, and work together with the team to come up with a plan for care following the transplant evaluation.
If suitable for transplant, patients must follow up closely with our center and inform their nurse coordinator of any changes in their health.
Life After a Lung Transplant
The goal of lung transplant is to help return a person to a better quality of life.
Patients have their pulmonary hypertension medications discontinued in the operating room, or soon thereafter.
Most patients usually stay in the hospital for 3-4 weeks, and stay in the Pittsburgh area for at least another month – if they are from out of town – after discharge.
When a lung transplant patient leaves the hospital, they:
- Have a new regimen for taking medicines at specific times of the day to suppress the immune system.
- Will take these medicines for the rest of their lives to help prevent the body from rejecting the transplant.
- Frequently need blood work – usually weekly for the first few months after transplant.
- Are seen in the clinic at UPMC routinely after transplant for testing for the duration of their transplant care.
Clinic visits involve pulmonary function tests, chest x-ray, and a bronchoscopy the next day to check for rejection or infection. Bronchoscopies are performed routinely every two to three months for at least the first two years. If either of these problems are found, they are treated, either at home or in the hospital.
Learn more information about the UPMC Lung Transplant Program.