The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on living donor lung transplantation for end-stage lung disease.
As part of the NICE's work programme, the current guidance was considered for review in July 2009 but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current.
Having a lung transplant from living donors instead of from someone who has just died (a cadaveric donor) may be a possibility. Transplants from living donors may be an option for patients who cannot get one from someone who has died. It may also be a possibility for patients who are getting worse so quickly that they are likely to become too ill to have a transplant while they are waiting for a cadaveric donor.
A transplant from a living donor may also be an option for critically ill children because, for them, there is a particular shortage of suitable donors who have died.
A transplant from living donors usually involves three operations, one on each of two donors and one on the recipient. The lower lobe of the right lung is removed from one donor and the lower lobe of the left lung is removed from the other donor. Both lungs are then removed from the recipient and are replaced by the lung implants from the donors in a single operation.
For the operation on the recipient the doctor makes an opening in the chest. While the main procedure is being done the recipient?s circulation is connected to a heart-lung machine (cardiopulmonary bypass). This machine does the work of both the heart and the lungs, pumping the blood around the body and supplying it with oxygen. The doctor removes the diseased lungs and then implants the donated lobes one after the other.
For the donor:
X45.3 Donation of lobe of lung
Z94.2 Right sided operation or Z94.3 Left sided operation
For the recipient:
E53.8 Other specified transplantation of lung
Y99.2 Live related donor NEC or Y99.3 Live unrelated donor or Y99.5 Live matched related donor or Y99.6 Live unmatched related donor
Y73.1 Cardiopulmonary bypass (if used)
Z94.2 Right sided operation or Z94.3 Left sided operation or Z94.1 Bilateral operation
The NHS Classifications Service of the Health and Social Care Information Centre is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. http://systems.hscic.gov.uk/data/clinicalcoding