Organ Failure Report – Lungs
The lungs are a vital organ forming a part of the respiratory system, which provides the body with a continuous supply of oxygen as well as a means of removing carbon dioxide. The life-sustaining oxygen that we inhale about 17,000 times a day passes from the lungs to the bloodstream, which then transports it to cells throughout the body. Respiratory failure occurs when an inadequate amount of oxygen flows from the lungs to the bloodstream.
Cause and Problems associated with Lung failure:
Lung failure is a very common medical condition globally and it results from problems in any part of the respiratory system shown above.
Lung disease affecting airways:
The Trachea branches into the Bronchi, the bronchi branch further to become smaller bronchiole tubes throughout the lungs.
• Asthma is one the most common lung diseases: The airways are persistently inflamed, and may occasionally spasm, causing wheezing and shortness of breath. Allergies, infections, or pollution can trigger asthma’s symptoms.
• Chronic obstructive pulmonary disease (COPD): Lung conditions defined by an inability to exhale normally, which causes difficulty breathing.
• Chronic bronchitis: A form of COPD characterized by a chronic productive cough.
• Emphysema: Lung damage allows air to be trapped in the lungs in this form of COPD. Difficulty blowing air out is its hallmark.
• Acute bronchitis: A sudden infection of the airways, usually by a virus.
• Cystic fibrosis: A genetic condition causing poor clearance of mucus from the bronchi. The accumulated mucus results in repeated lung infections.
Lung disease affecting alveoli:
The airways eventually branch into bronchioles which terminate into clusters of air sacs. The alveoli make up most of the lungs.
• Pneumonia: An infection of the alveoli, usually by bacteria.
• Tuberculosis: A slowly progressive pneumonia caused by the bacteria Mycobacterium tuberculosis.
• Emphysema results from damage to the fragile connections between alveoli. Smoking and pollution are the usual causes.
• Pulmonary edema: Fluid leaks out of the small blood vessels of the lung into the air sacs and the surrounding area. One form is caused by heart failure and back pressure in the lungs’ blood vessels; in another form, direct injury to the lung causes the leak of fluid.
• Lung cancer has many forms, and may develop in any part of the lungs. Most often this is in the main part of the lung, in or near the air sacs. The type, location, and spread of lung cancer determines the treatment options.
• Acute respiratory distress syndrome (ARDS): Severe, sudden injury to the lungs caused by a serious illness. Life support with mechanical ventilation is usually needed to survive until the lungs recover.
• Pneumoconiosis: A category of conditions caused by the inhalation of a substance that injures the lungs. Examples include black lung disease from inhaled coal dust and asbestosis from inhaled asbestos dust.
Lung disease affecting chest wall
If there is damage to part of the brain controlling the lung muscles or nerves, the poor function in nerves that control the respiratory muscles will result in difficulty breathing and lung failure.
Treatment by medicine
Support by ventilators or lung support machines / iron lungs
Stem cell treatment
Lung transplantation is a surgical procedure in which a patient’s diseased lungs are partially or totally replaced by lungs which come from a donor. Donor lungs can be retrieved from a living donor or a deceased donor. Depending on the disease, recipients may require one or two lungs.
Lung transplant carry certain associated risks whereas they can also extend life expectancy and enhance the quality of life for last stage pulmonary patients.
There are several situations where a lung transplant may be considered a viable option. These include, but are not limited to:
• End-Stage Lung disease
• Bronchopulmonary dysplasia or chronic lung disease
• Pulmonary hypertension
• Heart disease or heart defects affecting the lungs
• Pulmonary fibrosis
• Alpha-1-antitrypsin deficiency
In general, patients with lung cancer are not eligible for transplants. However, this depends on the type of lung cancer.
The most common reason for lung transplant is various kinds of COPD followed by other diseases.
However, the first successful transplant surgery involving the lungs was a heart-lung transplant, performed by Dr. Bruce Reitz in 1981 for a case of pulmonary hypertension.
When lung transplants were first thought of, all attempts were unsuccessful due to organ rejection and hence loss of life . There are many criteria for a donor to be able to give a lung, various physical, mental and financial capabilities must be met. Failure to do so will require a different donor.
As quoted by Web MD, a lung transplant is an effective treatment for disease that has destroyed most of the lungs function”. Hence, the transplant will improve overall health with improved respiratory abilities and increase lifespan.
As per data from Florida Hospital, there are many side effects from a successful lung transplant and from the drugs required post surgery:
Blocked blood vessels in way of the new lung/lungs
Blocked bronchi and bronchioles
Fluid in lungs
Effects of anti reject-ant and other drugs include:
Lower general immunity of the system
Vulnurable to small diseases
Effectiveness of Lung Transplant:
According to data from wikipedia, transplanted lungs usually last approximately 3-5 years before showing signs of failure.
Treatment for respiratory failure include:
High levels of oxygen being pumped into the patients lungs
Steroids and Antibiotics
Palliative care team
Due to the shortage of donor lungs in most countries and broadening demand for lung transplantation has led increased waiting list mortality.
Lung Allocation Score (LAS ) is a numerical value used to assign relative priority in distributing donated lungs.
The LAS evaluates several parameters of patient health to direct organ donation toward patients obtaining greatest benefit from lung transplantation .
Lung transplants can be seem as a last resort to most patients as not only is it risky but, after various treatments and medicinal use extremely expensive. As per John Hopkins university, patients often need to spend more than 117000 USD to pay for medicines, stay and future treatment.
Hence, lung transplantation results in survival and quality of life gains but remain expensive and low cost-effectiveness.
However those who are financially capable may seem this is the ideal solution to one with destroyed lungs.