Sarcoidosis is an inflammatory condition where the immune system mistakenly attacks the body’s own tissues. Immune cell clusters known as granulomas accumulate in organs and tissues. Most cases are short-term or mild, but long-term chronic cases can cause serious organ damage.
Because sarcoidosis often responds to treatment or may resolve without treatment, surgery is rare. However, severe and extensive damage to organs like the lungs, heart, or kidneys could necessitate organ transplant.
Lung transplant surgery
Lung damage and scarring are common complications of sarcoidosis, occurring in 20-30 percent of all cases. If this damage is extensive, a lung transplant may be advised.
One or both lungs could be replaced in a procedure an invasive chest surgery. Depending on its nature, the surgery takes from four to 12 hours, and involves an extended hospital stay for recovery.
Heart surgery
If the heart is severely affected by sarcoidosis, a heart transplant may be performed. A pacemaker may also be implanted in a patient’s chest to help regulate heart function.
The pacemaker is inserted into the chest, and a needle is used to thread the wires into the correct placements in the heart. The surgery can take several hours, but typically only requires an overnight hospital stay, where the heart’s function is monitored.
Kidney transplant surgery
For kidney complications associated with sarcoidosis, a kidney transplant may be considered. This operation usually takes around three hours, and replaces a damaged kidney with one from a living donor or from a matched but deceased person. Recovering from a kidney transplant requires a hospital of at least a few days.
Risks associated with surgery
Surgery for sarcoidosis is considered to be a treatment approach of last resort, and carries risks. However, if necessary and successful, it could lengthen lifespan and improve quality of life.
As in all surgeries, there is a risk of lingering pain and infection at the site of the surgery. Organ damage from surgery, especially in the chest, is possible, as are complications due to blood clotting and fluid buildup. These may require additional surgeries to fix.
Organ transplantation, in particular, carries risks of rejection. Patients will need to take immunosuppressant medications for the rest of their lives to prevent rejection. Although immunosuppressants may have the added benefit of reducing the progression of sarcoidosis itself, they also increase a person’s vulnerability to infection and sickness.
The general anesthesia used during surgery carries a risk of an allergic reaction. Since sarcoidosis can affect multiple organs, including the liver and kidneys, different drugs and dosing may need to be considered.
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