Surgical Options
Single Lung Transplant – If the recipient is having a single lung transplant, he/she will have a thoracotomy incision either on their right or their left side, depending on which lung is being replaced. After the donor lung arrives in the operating room, the surgeon will remove the diseased lung. The recipient will be ventilated using the other lung. If the remaining lung is not able to exchange enough oxygen, the surgeon may place the recipient on cardiopulmonary bypass. Their blood will be filtered through a machine outside the body which will put oxygen into their blood and remove carbon dioxide.
Three connections will be used to attach the new lung. These connections are called anastomoses. First, the main bronchus from the donor lung is attached to the recipient’s bronchus. Then, the blood vessels are attached, first the pulmonary artery and then the pulmonary veins. Finally, the incision is closed and the recipient will be taken to the intensive care unit, where he/she will be asleep for approximately 12-24 hours.
Double Lung Transplant - If both lungs are transplanted (a bilateral transplant), the surgeon will make an incision below each breast, called an anterior thoracotomy, or an incision that goes from the right side to the left side at the base of the breasts. This is called a transverse sternotomy incision. In a bilateral lung transplant, each lung is replaced separately. The surgeon begins by removing the lung with the poorest function. The recipient will be ventilated using their remaining lung unless partial cardiopulmonary bypass is needed. Once the first lung is removed, a donor lung will be attached using three connections — the donor bronchus is attached to the recipient’s main bronchus, then the blood vessels are attached, first the pulmonary artery, then the pulmonary veins. The recipient’s second diseased lung is removed and the other new lung is attached just like the first one. Once the second lung is completely connected, blood flow is restored.
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