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Lung transplantation for silicosis and recovery: an Australian case study

11 February 2021
Professional
02 February 2021
Volume 30 · Issue 3

Abstract

Lung transplantation is a well-established treatment for a variety of end-stage pulmonary diseases. However, the journey of a lung transplant recipient is complex and multifaceted. Silicosis is a rare indication for lung transplantation, but no other treatment is yet available for this disease in its end stages. This Australian case study presents a 52-year-old man with silicosis who received bilateral lung transplantation. The patient was frequently noncompliant with noninvasive ventilation therapy and experienced the complication of type 2 respiratory failure. Patient education and support provided, particularly around medication management following transplantation surgery, are discussed here. The patient's social situation and its implications for both him and his family are also considered.

This case study presents Mr Churi (not his real name), who received a bilateral lung transplant in Australia for silicosis. After introducing the patient and his history, this case study explores the pathophysiology of silicosis and the reason for transplantation. It discusses some elements of Mr Churi's postoperative recovery including his experience of type 2 respiratory failure (T2RF) and noncompliance with noninvasive ventilation (NIV); nursing care and management in this area are considered. Challenges in patient medication education are discussed and, finally, social implications during recovery after lung transplantation are explored.

Over the past three decades, lung transplantation has become a well-established treatment for a variety of end-stage pulmonary diseases (Hachem, 2018a). In Australia, lungs are the second most commonly transplanted organ; 222 lung transplants were performed in 2018, compared with 150 10 years previously (ANZOD Registry, 2019). This mirrors the international experience, in which the incidence of lung transplantation is growing along with the rate of post-transplant survival (Yusen et al, 2013). Although lung transplant survival rates are climbing, post-transplant complications persist (Gutierrez-Arias et al, 2016).

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Lung transplant
Silicosis
Nursing
Respiratory failure
Non-invasive ventilation
Patient education
Medication management