Matching the donor lung to the right patient waiting for transplant is a complex process. Blood type, height, size of the chest, lung allocation score and other factors are considered when a donor becomes available. No one knows exactly when this availability will occur.
When a good donor becomes available for you, you will be called by the transplant coordinator. Your coordinator will ask you about your current health, any recent antibiotics, and any medical issues that might make the transplant need to be postponed. You will be asked to come to the hospital as soon as possible.
It is important not have anything to eat or drink after being called for a transplant. It is also important to get to the hospital as soon as it is safely possible. You may need to have someone drive you to the hospital. Any special travel arrangements should be made long in advance.
There will be a lot of activity once you get to the hospital. You may be admitted to a bed on the cardiothoracic surgery floor or to the emergency room. Where you are admitted depends upon how long it will take to recover the donor lungs. Regardless of where you are, you will have blood drawn, get a chest X-ray, get a bath with special soap, and get medicine to clean out your bowels.
While you are waiting for the operation to start, you will meet with several doctors. The thoracic resident will review your history and do a physical exam. The anesthesiologist will talk to you about how you will be put to sleep and the types of monitoring you can expect during the operation. The transplant surgeon will see you when we know whether we can proceed with the operation.
The initial whirl of activity and tests is usually followed by a wait, while the team finds out if the lungs are good enough to use for transplant. Sometimes the lungs cannot be used. They will only know for sure when the transplant surgeon who is recovering the lungs has a chance to see them. If the lungs cannot be transplanted, you will go home. This is called a “dry run.” The on-call transplant team will attempt to keep you informed of how things are progressing.
Once the doctors have decided that the lungs are good enough to use for your transplant, you will be taken to the operating room (OR) holding area. Two members of your family may join you at this time. The rest of your family should wait in the intensive care unit (ICU) waiting room. While in the OR holding area you will receive some medicine to make you sleepy, but you will still be awake. Once you are taken back to the operating room, the anesthesiologists will put you to sleep.
The on-call transplant team will expect your family members to be in this ICU waiting room for updates about how your operation is going. Depending on the established procedures in the hospital you’re at, the on-call coordinator will keep the family updated about the surgery. A social worker or transplant coordinator may also look for your family to counsel them during the procedure.