Bronchiectasis is caused by the build-up of mucus. When the airways become blocked, due to the build-up of mucus, the airways stretch, causing abnormal enlargement. This build-up of mucus also causes the destruction of cilia. Since cilia work to remove debris from the airways, once they are damaged and are unable to function, bacteria begin to accumulate; this causes infections to develop. Since bronchiectasis causes blockage of the bronchial tubes, it is considered to be an obstructive lung disease.

Bronchiectasis is classified by its severity.
Cylindrical bronchiectasis is the most common form of bronchiectasis. This type of bronchiectasis is characteristic of a slight widening of the airways and is typically reversible. Cylinderical bronchiectasis is generally seen after an acute bout of bronchitis. Varicose bronchiectasis is characteristic of bronchial walls that have extended and collapsed in some areas. Cystic bronchiectasis is the most severe. This type of bronchiectasis is irreversible because the ballooning it causes in the bronchi is so severe.

Please go to this site(s) and become an organ donor today.

http://www.organdonor.gov/

http://www.unos.org/

On the Waiting List

After being accepted as a transplant patient, you will be placed on the "waiting list" for your lung(s). First, your name and identification code are entered into a national computerized waiting list, called the United Network for Organ Sharing (UNOS), along with your weight and blood type. Recipient and donor are matched by blood type and body and lung size. Individuals awaiting lung transplantation are prioritized according to criteria determined by UNOS.

UNOS maintains a centralized computer network linking all organ procurement organizations and transplant centers. The network is available 24 hours a day, seven days a week. When a donor becomes available, the organ procurement organization will access the UNOS computer, which generates a list of waiting patients ranked according to the policies for the available organ(s).

Each state may keep its own organs before offering them out of state. Organs from Indiana donors are only offered out of state if all transplant centers in the state have turned down the organs for their recipients. Organs are usually declined because of blood type incompatibilities, size mismatches, recipient illness or data indicating the organ may not be suitable for transplantation due to inadequate function or poor medical/social history.

Waiting Period

Because of the critical organ shortage, the average wait for a lung transplant at Clarian is about 24 months. No one can predict how long it will take to find a donor for you. Effective May 2005, UNOS implemented new lung allocation guidelines. All patients will be assigned an allocation score based on their medical condition at listing. Patients with the greatest need are transplanted first.

Waiting patients are seen in the followup clinic every five to six months. They will require a six-minute walk and pulmonary functions test to reassess their status on the waiting list.

When you are listed, the transplant coordinator will assist you in getting a pager. The pager gives the transplant team 24-hour access to you while you resume your daily activities. You will be called at home first when a donor lung becomes available. If you are not at home, you will be paged.

When You Are Called

Timing is important once a donor lung becomes available. The transplant coordinator will instruct you where to arrive at the hospital. Do not eat or drink anything after you have been called for your transplant. You will be admitted to the hospital and have blood work drawn and a chest X-ray performed.

You and your family must realize that plans for the transplant may change. If there is any sign of a donor problem, your transplant will not be performed. For your benefit and safety, we want to use a strong and healthy organ for your transplant.

Likewise, your transplant could be delayed if you have an unexpected health problem. We would not want to transplant a patient who has an infection. This is because medicines used to keep you from rejecting your new lung will impair your ability to fight infection. During this waiting period, it is important that you make your coordinator aware if you have any serious colds, a productive cough or fever.