After you leave the hospital you will have periodic appointments in the lung transplant clinic. These visits will include blood work, X-rays, a physical exam,and pulmonary function tests. These visits will be scheduled as often as your condition dictates. In addition to these appointments, blood work will be monitored regularly for drug levels, chemistries, and complete blood count. Your transplant team will show you how to fill out the requisitions for your blood work and chest X-rays. Your transplant team will also tell you when you should have these studies done.
Your doctor at home will be updated on your progress and needs. You should see your home doctor soon after you leave the hospital, preferably within one week.Seeing your doctor soon after returning home is important so that he or she sees you when you are well.
You will need to schedule an appointment for an annual physical with your family doctor soon after returning home. The immune suppressing medicines increase your risk for cancer, especially skin cancer. A routine skin exam should be done by your family doctor every three months.
Female patients should schedule a gynecologist appointment soon after returning home. Annual PAP smears and breast exams by your doctor are recommended. Monthly self-breast exams should become part of your routine. You should also follow you doctor’s recommendations regarding regular screening mammograms. Male patients should learn and perform monthly self testicular and breast exams.
A bronchoscopy is a test that looks at the main windpipe, called the trachea, and the bronchial tubes of your lungs. A trans-bronchial biopsy is a test which takes a small piece of lung during a bronchoscopy. These tests are done many times after your transplant to monitor for acute rejection.
You will have a bronchoscopy a few days after your transplant and then one, three, six, nine and 12 months after your transplant. This schedule of routine bronchoscopies may change if your needs require a biopsy at different times.
During the bronchoscopy the doctor puts a flexible tube through your nose or mouth, into your throat, past your vocal cords, and into your lungs. This tube is called a bronchoscopy and is about the diameter of a pencil. The bronchoscopy is like a flexible telescope with a light. The doctor will be able to look into different parts of your lungs.
A bronchoscopy is a safe test, but there are some risks. You may have some coughing, hoarseness, or nasal stuffiness after the test. You may also cough upa small amount of blood. Large amounts of bleeding are unusual. Less than 10% of the time a small portion of the lung may collapse. This complication is called a pneumothorax. You will have a chest X-ray after the test to check your lungs. A small pneumothorax may heal on its own, but a chest tube may be needed for a short time.
It is very important that you have an empty stomach before your bronchoscopy so that you do not vomit during the study. DO NOT eat or drink anything after midnight the night before your bronchoscopy. You may take your medicines with a small amount of water in the morning of your test. If you take insulin, check with your transplant team for special instructions regarding your insulin dose.An IV (a small tube in a vein) will be started before the bronchoscopy. You will be given some medicine to help you relax and make you sleepy. You will not be completely asleep during the bronchoscopy. Your heart rhythm, blood pressure,and oxygen saturation will be monitored during the bronchoscopy. You will take some nebulized medicine to numb your throat prior to starting the procedure.The doctor will put the bronchoscope into one of your nostrils or through your mouth and move it down your throat. You will be able to feel the tube at the back of your throat and windpipe, but it does not hurt. You may feel a tickle and may need to cough. Be careful not to talk while the tube is in your windpipe, as talking may cause more hoarseness.
The lights in the room will be dimmed as the doctor examines your airways through the bronchoscopy. The whole test lasts 30 to 60 minutes.After the bronchoscopy, you will be monitored while the medicines wear off. You will be able to eat a few hours after the bronchoscopy. The medicine that you receive during your test can interfere with your gag reflex and you could choke if you eat or drink too soon. These medicines may make you feel dizzy, cause you to lose your sense of balance, and slow your reaction time. You must have someone to drive you home after your test.
The results from your biopsy will sometimes be ready the same day or the next day. Some test results from the bronchoscopy will take several days to comeback. The transplant team will call you with the test results.
Fortis Memorial Research Institute, Lung Transplant Guide
Reasons For Transplant
Lung Transplant Evaluation, Allocation, Scoring & Matching
Waiting For An Organ Donor
Getting The Call
The Lung Transplant Operation & Post-Operative Stay
Living With New Lungs – Rejections & Infections
Things You MUST Know After a Lung Transplant