Lung Transplant Program

A donor lung can become available at any time of the day or night. Timing is critical - you need to arrive as soon as possible.

We often need to have your child ready to go to the operating room within hours of your arrival at Children's Hospital Boston, so things will happen very quickly. It is very important to plan ahead for when this occurs.

When you receive the phone call from the transplant team to come to the hospital, be prepared to:

What happens when we arrive at the hospital?

When you arrive at Children's Hospital Boston, you will go directly to the Transplant Unit, or 10T, an inpatient unit designed for solid organ transplant patients.

What happens when I get to the hospital?

Upon arrival to 10T, the doctors and nurses will exam your child, obtain certain specimens, obtain a chest x-ray, and draw some blood. This is to make sure your child is ready to go to the operating room. If your child has an upper respiratory infection or a temperature, the transplant team will then determine whether or not it is safe to go ahead with the operation.

While on 10T, you will meet and discuss the upcoming surgery with the surgeon and anesthesiologist. This is a good opportunity to go over any questions or concerns you might have about the surgery and to sign consent forms.

What happens in the Operating Room?

Once in the operating room, you will be greeted by the OR nurses and anesthesiologists who will be involved in your child's care during surgery. Your child will be given anesthesia to help him sleep and his chest will be thoroughly washed with a special cleansing solution to minimize the possibility of infection.

Often the anesthesiologist will allow you to take your child into the operating room and stay with them until they are put to sleep.

While all of this preparation is going on, a surgical team will be obtaining the donor lungs. The time of the operation is planned to match the team's arrival back to the hospital. Ideally, lungs are transplanted within four to six hours of being outside the body.

How long will the transplant operation take?

The transplant operation involves removing the damaged lung from your child's body and attaching the new lung. The transplant operation takes anywhere from six to twelve hours.

Parents and family members should wait in the main surgical waiting area, on the third floor of the main building. You will receive progress reports every few hours during the operation.

What happens after surgery?

After the surgery, your child will go to an intensive care unit (ICU) to be monitored closely. After your child is stable, family may come in to visit.

Your child will be attached to several tubes, drains and intravenous lines. These include:

• Ventilator
  This tube, which comes out of your child's mouth, helps with breathing. While your child is attached to the ventilator, he will be unable to speak. Depending on how your child responds to surgery, the breathing tube could potentially be removed as early as the next day after surgery or several days later.

• Chest Tubes
  Your child will have four chest tubes inserted into his chest during surgery that will help drain blood and fluid. Once there is minimal drainage, the decision will be made by the surgeon to have the drains removed.

• Naso-gastric tube
  Another tube that you will notice is the naso-gastric tube which is inserted in your child's nose and goes down into the stomach. This tube will keep the stomach empty and prevent feelings of nausea or vomiting.

• Arterial line (ART)
  This hollow plastic tube will be placed in your child's wrist, elbow, or groin. It allows the nurses and doctors to observe your child's blood pressure continuously.

• Catheters
  An epidural catheter will be inserted in your child's back to administer continuous pain medicine. The ICU nurses are very good at monitoring for pain and we will take every measure to keep your child comfortable.

• Central line
  A central venous catheter will be inserted into a vein in your child's neck or groin. It is used to deliver fluids, nutrition solutions, antibiotics or blood products directly into your child's bloodstream without frequently having to insert a needle into their vein.

• Urinary catheter
  A catheter will also be inserted in your child's bladder to monitor urine output. It is imperative for us to keep a close watch on your fluid status so the new lungs do not become fluid overloaded. Therefore this catheter may not be removed until a few days after surgery.

The length of time your child will spend in the ICU will vary based on your child's unique condition. After your child is stable, he will be sent to the Transplant Unit.