“Transplanted people have a double gratitude: National Donor Day, in which for many years they have expressed their gratitude to the donor and encourage donation; and the National Transplant Day, which is to thank and encourage the professionals who make it possible to continue their line of improvement, in quantity and quality. There are many people who are mobilized for a transplant. This day is an opportunity for the transplanted patients to express their gratitude publicly”. Spanish Federation of Cystic Fibrosis (FEFQ)
According to the National Transplant Organization (ONT) of Spain, 4,425 transplants were performed in the country in 2020. Of these, 336 were pulmonary (lung transplant patients).
If we talk about lung transplantation, in our country there are a number of reference hospitals and the Vall d´Hebrón Hospital in Barcelona is one of them, since it continues to be the leader in the number of lung transplants according to data from 2020.
In this last year, and due to the COVID-19 pandemic, the number of interventions has decreased and the waiting list for transplants has suffered an increase in the delay time. In addition, the follow-up of the patients has mainly been telematically.
The number of patients who need and await a transplant is greater than the number of donors available. About 10% of the total are waiting to receive their transplant
Of the total number of patients who are on a waiting list or who receive a transplant, 5% are pediatric.
The waiting process to find the compatible donor and perform the intervention can be very long. In Spain, it usually lasts an average of 250 days, while in England, it is 326 days.
The most common pathologies of patients who receive a lung transplant are: Chronic Obstructive Pulmonary Disease (COPD), Pulmonary Fibrosis, Pulmonary Hypertension, Bronchiectasis, Alpha-1 antitrypsin, or Cystic Fibrosis, as the disease causing the highest percentage of transplants in age pediatric.
What types of lung transplants are there?
- Single-lung transplantation: transplantation of one lung.
- Two-lung transplantation: transplantation of both lungs.
- Cardiopulmonary transplantation: transplantation of both lungs and the heart.
- Lobar transplantation: transplantation of a part of a lung. The person who receives it is usually a child.
Physiotherapy in the pre-transplant phase
Patients who opt for a transplant have some characteristics in common such as:
- Respiratory insufficiency
- Poor tolerance to aerobic exercise
- Limiting dyspnea
- General loss of muscle mass.
Respiratory physical therapy is an important part of pulmonary rehabilitation in the transplant patient. The physiotherapist begins to work with the person receiving the transplant in the phase prior to its completion so that it is in good condition as well as later for its recovery. This treatment will be adapted to the needs of each person at each moment of the process.
The respiratory physiotherapist will help the patient in various aspects such as the respiratory part and the physical part.
Respiratory physiotherapy through maneuvers that can be manual as well as instrumental, some of these exercises will be:
- Directed ventilation exercises
- Exercises to control the rhythm of breathing (mixture of slow and fast breaths), inspiratory volumes (the amount of air taken in when breathing) and speed of the expired flows (speed at which the air is breathed in during breathing)
- Abdominal-diphragmatic breathing exercises: Breathe directing the air towards the abdomen, swelling the gut as if you wanted to explode the button on your pants.
- Rib expansions.
- Secretion drainage exercises for bronchial cleansing.
- Muscle strengthening: With weights of 1-2 kg of weight. The main muscles in both extremities are worked.
- Upper or Arms: Pectoral, deltoid, trapezius, latissimus dorsi, biceps and triceps.
- Lower or Legs: Quadriceps, glutes and sural triceps.
- Balance exercises in sitting and standing.
- Active leg exercises
- Aerobic training on a stationary bike and / or treadmill with saturation control.
After 3-4 weeks the patient learns the exercise routine, and depending on his evolution the professional will indicate the following steps. It has to be maintained as actively as possible with the help of supplemental oxygen if necessary.
The Lovexair Foundation team of respiratory physiotherapists is available to answer questions (lung transplant) or queries. You can also join the insp@ir Community to connect with others who share your lung health concerns.
Última actualización realizada el 9 April, 2021