A lung transplant is surgery done to remove a diseased lung and replace it with a healthy lung from another person. The surgery may be done for one lung or for both. Lung transplants can be done on people of almost all ages from newborns to adults up to age 65 and sometimes even later.
Types of lung transplant procedures include:
Most lungs that are transplanted come from deceased organ donors. This type of transplant is called a cadaveric transplant. Healthy, nonsmoking adults who are a good match may be able to donate part of one of their lungs. The part of the lung is called a lobe. This type of transplant is called a living transplant. People who donate a lung lobe can live healthy lives with the remaining lungs.
A lung transplant may be advised for someone who:
A lung transplant may be needed for the following conditions:
Not all people with these conditions need a lung transplant. A lung transplant is not advised as a treatment for lung cancer. Your healthcare provider may have other reasons to advise a lung transplant.
All procedures have some risks. The risks of this procedure may include:
Rejection is major risk of transplant. This is a normal body reaction to a foreign object or tissue. When an organ is transplanted into a person's body, their immune system sees it as a threat and attacks the organ. To allow the transplanted organ to survive in a new body, medicines are used to trick the immune system into not attacking the transplant. The medicines used to prevent or treat rejection have a lot of side effects. The exact side effects will depend on the specific medicines that are taken.
In some cases, a person shouldn’t have a lung transplant. Reasons for this can include:
Your risks may vary depending on your general health and other factors. Ask your healthcare provider which risks apply most to you. Talk with him or her about any concerns you have.
To get a lung from an organ donor who has died, you will first be evaluated by a transplant team. The team may include:
The transplant evaluation process includes:
The transplant team will consider all information from interviews, your medical history, physical exam, and diagnostic tests in deciding your eligibility for a lung transplant.
Once you have been accepted as a transplant candidate, you will be placed on a waiting list of the United Network for Organ Sharing (UNOS.) Waiting times vary greatly. They depend on which organ(s) you need, your age, your blood type, and the reason for your transplant. People who are unable to wait may be considered for lung transplant from a living donor.
When a donor organ is available from a deceased person, you will be notified and told to come to the hospital right away so you can be prepared for the transplant. If you are getting a lung from a living donor, the transplant can be done at a planned time. The potential donor(s) must have a compatible blood type and be in good health. Psychological tests will be done to be sure the donor is fine with the decision.
Before the transplant:
Your healthcare providers may give you other specific instructions to get ready.
Lung transplant requires a stay in a hospital. The way the procedure is done may vary. It depends on your condition and your healthcare provider's methods. In most cases, the procedure will follow this process:
After the surgery you may be taken to a recovery room. You will then be taken to the intensive care unit (ICU). This is a ward in a hospital where you will be watched closely. You will be in the ICU for several days. You will be in the hospital 7 to 14 days or longer.
When your healthcare provider feels you are ready, you will be moved from the ICU to a private room on a regular nursing unit or transplant unit. Your recovery will continue there. You will increase your activity by getting out of bed and walking around for longer periods of time. Catheters and tubes will be removed. Your diet will be progress to solid foods.
Nurses, pharmacists, dietitians, physical therapists, and other members of the transplant team will teach you and your significant family members how to take care of yourself once you are discharged from the hospital.
You will have follow-up visits often after leaving the hospital. These visits may include:
The transplant team will explain the schedule for these tests. Your rehabilitation program will continue for many months.
Call your healthcare provider if you have any of the below:
Your healthcare provider may give you other instructions after the procedure.
To allow the transplanted lung(s) to survive in your body, you will take medicines for the rest of your life to fight rejection. Each person may react differently to the medicines. Each transplant team has preferences for different medicines. Healthcare providers tailor medicine plans to meet the needs of each person. In most cases, 3 types of antirejection medicines are given. Antirejection medicines affect the way the immune system works, so people on these medicines have a higher risk for infections. The doses of these medicines may change often, depending on your response. While taking these medicines, you will be more likely to have certain infections. These include oral yeast infection (thrush), herpes, and respiratory viruses. For the first few months after surgery, make sure to avoid crowds and anyone who has an infection. Do not hesitate to restrict visitors to your home while you are recovering. Stay away from any people or places where smoking is allowed and do not allow smoking in your home.
Call your transplant team if you have signs of rejection, such as: