Vidisha Singh Lung Transplant Lungs are the largest portion in our respiratory system, they are capable of breathing 20, 000 times a day. We have two lungs. The right lung is on the right side of the chest cavity and the left lung on the left side of the chest cavity, but the left lung contains two lobes. Each lobes of the lung is like a balloon filled with spongy tissues and they are responsible of exchanging gasses, from Carbon dioxide to oxygen and visa versa. (Lee Woodard, 2011) This essay will help provide some information Figure 1: Comparison of a healthy lung and a lung of a smoker. (Lungs Transplant, 2011) on what lungs are, the reasons for lung transplant, the basic procedure of a lung transplant, the advantages and the disadvantages, the One-‐World Issue (Cultural and Economical issues) and my perspective. Lungs being the important part of the body should be protected and the symptoms should be considered. (look at figure 1 for a comparison of a smoker’s lung and normal healthy lung) If a person has failed lungs (can be one or both) should get a lung transplant. It is important to know the symptoms of lung failure, some examples are: permanent enlargement of air sacs (alveoli) with loss of completely exhaling (emphysema), heredity lunch blockage (cystic fibrosis), long-‐term (chronic) Figure 2: Before the transplant procedures (Admin, 2008) inflammation (sarcoidosis) and permanent scarring and thickening of lung tissue (idiopathic pulmonary fibrosis). These symptoms should be considered and checked if any appear. (Lung Transplant, 2011)
Vidisha Singh If the symptoms appear, then a transplant is needed unless the doctor advices better options. But if the transplant is needed then to get the transplant, there needs to be many things that need to be considered and checked like; (see figure 2 for before the transplant procedure) donation of new lungs by a person who has been declared brain-‐dead but remains on life-‐support. The donor’s tissue must be matched as closely as possible to that recipients’ to reduce the chances of transplantation tissue being rejected. When the recipient is unconscious and pain-‐free, an incision is made on the chest. Tubes are used to re-‐route blood to the heart-‐lung bypass machine to provide oxygen during the surgery. (Lung Transplant, 2008) One or both lung could be removed, and the donor’s lungs are stitched. Chest tubes are inserted to drain out air, fluid, and blood out of the chest for several days so the lungs can fully re-‐expand and recover. Sometimes heart and lung transplantation are done together, if heart is diseased. (Lung Transplant, 2011) For every transplant, there are bright sides and there are also downsides. But looking on the bright side of this transplantation, there are many benefits to the recipients after he has the transplantation. The benefits are that even though the recipient loses one damaged and malfunctioned lung, but gains back the lung but more healthier. (Lung Transplantation, 2011) Following that the recipient will have a cleaner lung with no infectious disease that will threaten the recipient’s life again unless the recipient has habits, which could damage the lungs again. But amazingly, after the transplant the recipient will have more energy, be more active and independent along with being able to gain weight easily. Luckily physicians have medications for rejection of new lungs called immune-‐suppressing drugs, this helps the lungs be settled into the body without any attack from the immune system. This transplant holds many benefits that will improve the patient’s life further.
Vidisha Singh Unfortunately there are not any transplants yet, which have not got any after transplant reactions or drawbacks in other words disadvantages. The downside of this transplant can get real risky if the new lung/s from the donor isn’t healthy, because the whole point of a transplant is to get new lung/s, which could improve life quality again. Other precaution that needs to be taken care of is the age of the donor and the blood type also the donor’s tissue must be matched. After the lung transplant is completed, the immune system may believe that the new lung/s are invaders and they will try to immunize them. This should be treated as soon as possible. This could be detected by the signs of rejection, which are; fever, flu-‐like symptoms (chills, dizziness, nausea, general feeling of illness, night sweats), increased difficulty in breathing, worsening pulmonary test results, increased chest pain or tenderness and/or increase of decrease in body weight of more than 2 kilograms in a 24 hour period. Lung transplant not being an easy transplant to do can cause quite a few deaths during the first 3 months, or first 5 years, this is why no specialist guarantees long life after the transplant (see figure 3 for more survival data). The risks after the transplantation are infection, internal/external bleeding and/or malfunction of the donor’s lung or even poor healing where donor’s airway attached to the recipient’s airway. Besides long-‐terms use of immune suppressing drugs can cause diabetes, kidney damage or infections that can kill the patient. Figure 3: Survival Data (OPTN/SRTR, 2009)
Vidisha Singh One World issues also concern the recipient or the donor and lung transplant. One of the One-‐World Issues that affects the lung transplantation idea is Cultural Issue. This issue has two sides that have different opinions. It is believed in some cultures that a person has to give back its organs to the Earth, take it to heaven or take his organs to his next life in order to gain salvation (freedom from the birth cycle) and/or nirvana. (Vicky R. Bowden, 2010) While on the other side cultures like Catholic Christians believe that it is good deed to save many people’s life just through one person’s donation. Few groups like the Shinto disfavor organ donation; these are cultures that follow the folk customs of the Gypsies. These cultural groups believe that the body should be returned back to god after the death of one or that body after death is impure. (BBC, 2009) While the Roman Catholic Church is in favor of organ donation, because it acts out like a charity and means of saving many lives just by giving in one’s. This is a Cultural-‐Ethical Issue, because it has ethical implication since Ethical issue evolves around making a choice based on what is ‘right and ‘wrong’ according to the laws, customs, rules or beliefs. The second One-‐World Issue that concerns the people is the Economical factor or in other words, Economical Issue. It is knows that basically all transplants costs a lot; even if most of the amount is paid by the insurance company. The costs that cover this are; the physician fee, admission fee, procurement, post-‐transplant admission, 30-‐day pre-‐transplant fee and Immuno-‐suppressant fee. (see figure 4 for transplant fees.)The fee also depends on how serious the case is and what type of lung transplant is wanted-‐ Single Lung, Double Lungs or Heart-‐Lung Transplant. It is mostly the high status people who have economic means support who are able to spend this much money without any worry for the transplant surgery. The U.S. Average 2008 First-‐year Billed Charges for a Single lung was $450, 400; Double lung
Vidisha Singh transplant cost was $657, 800 and Heart-‐Lung transplant cost $1, 123, 800 in 2008. Normally this issue concerns a lot of people because of their economic means support and the insurance support. Figure 4: Fees covered in the transplant (Financing A Transplant, 2010) This lung transplant essay covered the topics of what lungs are, reasons for lung transplant, basic procedure of lung transplants, the advantages and the disadvantages and the One-‐World Issue. My belief and view on lung transplant is that the cultural-‐ethical belief of different people is quite interesting because of difference of thoughts and opinions, another thing that takes me back is the precautions, the symptoms before and after the lung transplant, it is quite fascinating how the science developed and is developing. To help resolve some problems dealing with Cultural-‐Ethical Belief is a very complicated and almost impossible complication to resolve, because a group’s law, customs and rules cannot be changed unless their leader/holy book or sprit advises them to. Though one thing
Vidisha Singh could be changed that is the reason why lung transplant are happening, if people manage to stop drugging their lungs or using any material or object that harms that part, then it would be more convenient, untroubled and life saving method to follow.
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