The most important conversation that a transplant
surgeon needs to have with any potential recipient relates to the planned transplant
surgical procedure. This involves describing what the actual procedure involves,
as well as any potential problems that can occur with the surgery followed then
by the expected post-operative course.
All
transplant surgical procedures are considered major operative procedures and there
are common elements which they all share-
a)
Making an
appropriate incision either on the chest or the abdomen to gain the required
access
b)
The surgical removal of the recipients own diseased organ
in the case of the lungs, liver and heart in order to make space for the new
organ to be transplanted. This also requires that some blood vessels and other
structures need to be preserved to assist with the next phase of the surgery.
c)
Implanting the new donor organ which involves suturing a
number of vessels and other pipes/structures that are specific to each type of
donor organ
d)
Ensuring that any other problems such as bleeding are then
dealt with
e)
Inserting drainage tubes and closing the incision
1)
In the case of kidney recipients, most of the time the
patient can be woken up from the anaesthetic and transferred to a ward or
step-down unit for close post-operative monitoring to occur
2)
For the heart, lung and liver recipients most patients are
kept asleep at the end of the surgery and transferred straight from the
operating room to the intensive care unit for ongoing close monitoring. This is
required until it is apparent that the patient is stabilising following the
surgery and that the newly transplanted organ is functioning.
The nature of
the surgery and the expected post-operative course can generate many other questions.
There are some general guides available including via the Internet. In
particular via the MedlinePus site in the United States- Liver transplantation heart transplantation kidney transplantation lung transplantation
However both the magnitude of the surgery as well as the range of possible complications do vary depending on both the organ being transplanted and how unwell each potential recipient is at the time of the transplant procedure -
 |
| The pieces of information that need to be put together for every transplant recipient including the last piece of information that can be obtained only during the actual transplant procedure. |
However both the magnitude of the surgery as well as the range of possible complications do vary depending on both the organ being transplanted and how unwell each potential recipient is at the time of the transplant procedure -
a) How each transplant recipient fares during the surgery and early on post operatively is
related to the many specific bits of information that need to be put together at the time-as
outlined in the above image.
b) It is important to remember that the last 2 pieces of the recipient information jigsaw
puzzle are only able to be put together in the operating room during the actual transplant
surgery. For example there is no test for how much scarring may be present in the
abdomen in a liver recipient who has undergone previous surgery, hence this can only be
determined during the actual transplant surgical procedure.
c) Also if the combination of all of the non-surgical pieces of information were to predict an
unfavourable outcome in advance for a recipient, then the transplant surgery would not be
able to go ahead.
Hence
specific advice should be sought by potential transplant patients and their
relatives from the transplant programme that they are currently in contact with. There
are both pluses and minuses from currently seeking health care advice only via
the Internet as outlined via the following link- Mashable- what-doctors-think-about-your-online-health-searches
Image designed by Deb Verran 2012: acknowledgement Presentation magazine
Image designed by Deb Verran 2012: acknowledgement Presentation magazine
