Lung transplant

Question

Dear physicians,

I would like to know whether transplanted lungs get less damaged by tenacious secretions because these are healthy lungs. How is the formation of tenacious mucus after a transplant?
Thank you for answering our question.

Answer

Dear questioner,

Indeed, after lung transplant, lungs will no longer suffer from CF, because the transplanted lungs have a normal function of the CFTR protein.
This is not the same as to say that no lung disease will happen after lung transplant. The patient still keeps his upper airways and also the trachea and the first part of the right and left mainstem bronchus. Chronic infection of the upper airways and the large airways with bacteria typical for cystic fibrosis can thus still occur.
The main problem after lung transplant is however chronic rejection. This means: the transplanted lungs are from a foreign person and the own body reacts against this foreign tissue. In some cases this will be severe and occur early on. In other cases, the match between the donor (foreign lung) and acceptor (patient who receives the new lung) is better. Because rejection needs to be avoided or diminished, patients who have a transplant need to take medicines that decrease their immunity. That will make the patient more vulnerable for infection. And also these repeated infections will contribute to damage in the transplanted lungs.
A lung transplant thus offers a new chance but not a cure. Typical problems will occur in the transplanted lungs. The patients thus- in a certain way- get a new disease. On the other hand we must state that by the transplant the quality of life and the chance of survival is clearly improved. Of a mean survival of 2 years without transplant the patient now has a mean survival of 7 to 10 years.
Prof. Kris de Boeck

03.05.2012