About Lung Transplant Programme

The National Heart Centre Singapore (NHCS) established its Lung Transplant Programme in 2000 and remains the only healthcare institution in Singapore that performs lung transplantation. To date, about 17 lung transplants have been completed, providing recipients with renewed quality of life. The Lung Transplant Clinic manages patients with end-stage lung disease and provides comprehensive pre‑ and post‑transplant care, including care for primary pulmonary hypertension.

Lung transplantation involves removing the diseased lung or lungs from the recipient and replacing either one (single lung transplant) or both (bilateral lung transplant) with healthy ones from a recently deceased donor.

Lung transplantation represents the best hope for patients with end-stage lung disease as it can offer patients better quality of life after the transplant.

Patients with end-stage lung disease – whose lungs can no longer obtain sufficient oxygen for the body, require lung transplantation. 

When the transplant team decides that a candidate is suitable for transplantation, the patient’s name will be placed on the waiting list.  Donor lungs are matched with recipients according to the following criteria: 

• Size (height and weight)
• Chest measurements (chest circumference & chest x-ray measurements)
• Blood type (O, A, B or AB)

The quality of the donor lungs is of the utmost priority. Donor lungs are thoroughly evaluated by the lung transplant team. The evaluation includes examination of the donor’s chest x-ray, medical history, social history (with particular emphasis on tobacco and substance abuse), amount of oxygen in the blood (arterial blood gases) and bronchoscopy.

Evaluation of the patient’s condition is currently done in the hospital where their underlying lung condition and prospects of a successful transplant are thoroughly reviewed.

During this evaluation period, the patient will meet and speak with various members of the transplant team:

• Transplant Pulmonologist: The physician who specialises in lung diseases and lung transplantation. 
• Transplant Surgeon: The surgeon who performs the operation and manages the post-operative care together with the Transplant Pulmonologist. 
• Transplant Clinical Coordinator: The main contact person from the transplant team. 
• Medical Social Worker: The person who assists in determining the patient’s financial and social ability to cope with a transplant. 
• Psychiatrist: The physician who helps to determine the patient’s ability to cope with the stress and anxiety of undergoing the transplant. 
• Infectious Disease Physician: The physician who specialises in infectious diseases. 
• Dietitian: The healthcare professional who assesses the patient’s nutritional needs before the transplant operation. 
• Physiotherapist: The healthcare professional who evaluates the patient’s exercise capacity and musculoskeletal system and recommends exercise programmes for the patient to increase body strength and endurance before and after the transplant.

The evaluation work-up will include a series of blood tests and the condition of the heart, lung, liver and kidney systems. Potential transplant recipients are required to be substance-free at least a year before being listed for the transplant. Harmful habits such as smoking and alcohol or mind-altering drug dependency must be avoided.

Common end-stage lung diseases which require Lung Transplantation include:

• Chronic Obstructive Pulmonary Disease (COPD)
• Idiopathic Pulmonary Fibrosis (IPF)
• Bronchiectasis
• Pulmonary Hypertension (Primary and Secondary)

Donors are individuals who are brain-dead, meaning that the brain shows no signs of life while the person’s body is being kept alive by artificial means. Most donors are those who have died due to road accidents, strokes or severe head injuries.

Depending on the availability of a lung for transplant, patients may have to wait for months to years.

Patients will be strongly encouraged to participate in a pulmonary rehabilitation programme. The programme focuses on monitored physical exercise to help patients build their strength and endurance in preparation for the transplant and increase the chances of a successful outcome following the transplant.