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Definition  

This is a surgery to remove severely diseased and damaged lungs. They are replaced with healthy lungs from a deceased donor. One or both lungs may be transplanted. In some cases, a heart transplant is done at the same time. In that case, the procedure is called a heart-lung transplant .

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Normal vs. Emphysemic Lung  
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Reasons for Procedure  

A lung transplant is done to treat irreversible, life-threatening lung disease, such as:

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Possible Complications  

If you are planning to have a lung transplant, your doctor will review a list of possible complications, which may include:

  • Infection
  • Bleeding
  • Rejection of the donor lung (your body's immune system attacks the new lungs)
  • Conditions related to taking immunosuppressant drugs
    • Infection
    • Cancer
    • Diabetes
    • Kidney damage
    • Osteoporosis
  • Anesthesia-related problems
  • Death

Be sure to discuss these risks with your doctor before the procedure.

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What to Expect  

Prior to Procedure  

Before you have a lung transplant, you will go through an intensive evaluation. This is done to determine if you are a good candidate for this surgery. During the evaluation, which often requires a hospital stay, you will have some or all of the following tests:

If you are a good candidate for a transplant, you will be put on a waiting list. There is a shortage of donors. You may need to wait a long time. You will need to carry a cell phone with you at all times. This will allow the transplant team to reach you if a donor lung becomes available. Donors are matched carefully for size, tissue type, and other factors. In some cases, a healthy family member can donate a lung if you only need a single transplant.

Leading up to your procedure:

  • Arrange for a ride to the hospital.
  • Take medicine as directed. Check with your doctor before taking over-the-counter medicine.
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Anti-inflammatory drugs (such as, aspirin )
    • Blood thinners, like clopidogrel or warfarin
  • Eat a light meal the night before. Do not eat or drink anything after midnight.

Anesthesia  

General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.

Description of the Procedure  

For a single lung transplant, the doctor will make an incision on your side. It will be about six inches below your underarm. For a double lung transplant, the doctor will make an incision across the lower chest.

You will be put on a ventilator and a heart-lung machine. This machine will take over the functions of the heart and lungs during surgery. Next, the doctor will remove a small section of rib. This will allow access to your lung. The old lung will be cut away from the main blood vessel and bronchus (large airway). The new lung will then be inserted. The doctor will attach the blood vessels and bronchus to the new lung.

Immediately After Procedure  

You will stay in the intensive care unit (ICU) for 2-3 days. The doctors and nurses will monitor you.

How Long Will It Take?  

  • 4-8 hours for a single lung transplant
  • 6-12 hours for a double lung transplant

How Much Will It Hurt?  

You will have pain during the recovery process. Your doctor will give you pain medicine.

Average Hospital Stay  

This surgery is done in a hospital setting. The usual length of stay is 7-10 days. Your doctor may choose to keep you longer if you shows signs of rejecting the new lungs or have other problems.

Post-procedure Care  

Arrange for help at home.

Ask your doctor about when it is safe to shower, bathe, or soak in water.

For the rest of your life, do the following to maintain the health of your new lung or lungs:

  • Take immunosuppressive drugs. These drugs will help to prevent your body from rejecting the new lung. Only take drugs approved by your doctor.
  • Have regular lung biopsies . A sample of lung tissue will be taken at regular intervals to check for lung rejection:
    • Every three months the first year
    • Twice a year the second year
    • Once a year in subsequent years
  • Have blood tests done.
  • You may need chest X-rays and EKGs.
  • Measure your temperature, weight, and blood pressure levels regularly.
  • Make lifestyle changes, such as:
    • Avoiding exposure to tobacco smoke and other toxic elements
    • Exercising regularly to help maintain lung capacity
    • Limiting your intake of salt, foods high in fat and cholesterol, sweets, and alcohol

It will take about six months to recover from a lung transplant.

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Call Your Doctor  

After you leave the hospital, call your doctor if any of the following occurs:

  • Signs of rejection including fever, chills, achiness like the flu, shortness of breath, decreased ability to exercise
  • Signs of infection including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Nausea and/or vomiting that you can't control with the medicines you were given after surgery or which persist for more than two days after you are discharged from the hospital
  • Pain that you can't control with the medicines you've been given
  • Cough, shortness of breath, or chest pain
  • Chest pain that is new or worse
  • Coughing up blood
  • Waking up at night due to being short of breath
  • Sudden headache or feeling faint
  • Changes in blood pressure or weight
  • Increase in phlegm production
  • Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine

Call for medical help or go to the emergency room right away if any of the following occurs:

  • Fast breathing or trouble breathing
  • Blue or gray skin color
  • Chest pain that is new or worse

If you think you have an emergency, call for medical help right away.