Lung Transplant
Why and how a lung transplant is done.

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What is a lung transplant?
A lung transplant is the surgical replacement of a diseased lung with a donated human lung. This is done for some severe lung diseases.

Why does the lung need to be replaced?
The lung is a vital organ. As we breathe air, our lungs exchange gases and fill our blood with crucial oxygen. Certain diseases can damage the lungs and make breathing difficult. Some diseases may even get worse to the point that you need a transplant.

Here are some examples of diseases that can lead to lung failure:

  • Chronic obstructive pulmonary disease (COPD)
  • Pulmonary fibrosis
  • Emphysema
  • Pulmonary hypertension
  • Cystic fibrosis
  • Sarcoidosis

Smoking causes many lung diseases and makes others much worse. If you smoke, you should talk to your doctor about quitting.

How is a lung transplant performed?
If you need a lung transplant, you're first put on a waiting list of lungs donated from people who have agreed to donate organs after death (also called cadaveric donors). There are more people waiting for new lungs than there are available donor lungs. It can take several years before you get an organ. At this time, there are not enough donor organs to go around even to the sickest. The United Network for Organ Sharing directs where the donated organs go.

As you're waiting for a new lung, your doctors will order blood tests and x-rays. If you smoke, you'll have to quit.

There are four types of lung transplants:

  1. Single lung. One lung is removed and replaced. You keep your other lung.
  2. Double lung. Both your lungs are removed and replaced.
  3. Heart-lung. A combination of a heart and double lung transplant at the same time.
  4. Living related lung transplant. One lung lobe is donated from each of two living relatives. This surgery is sometimes offered to someone who is too ill to wait for a cadaveric lung.

Any type of lung transplant is a major operation. After you're put to sleep (under general anesthesia), your chest is opened up and your lung is taken out. The new donated lung is put in your chest and the surgeons reconnect blood vessels to the new lung.

Once the new lung is working, the surgeons close your chest and you go to the intensive care unit to recover. You'll have a large scar down your chest.

How long does the procedure take?
The operation can take several hours. If you have had any type of chest surgery in the past, the surgery can take much longer. You may spend several weeks in the hospital recovering from the surgery.

What are the risks?
Like any other major surgery, there is always a risk for bleeding, infection and death with a lung transplant.

Your body may also reject the new organ. This happens when your body's immune system sees the organ as foreign and starts attacking it. The new lung may stop working and you may need to go back on the waiting list for a replacement.

You'll be given many different types of medicines after a transplant, and each of those have side effects and risks. You need them to prevent rejection.

If you'll be getting a lung transplant, it's very important to find a good medical center that has a record of doing many successful lung transplants.

By Louis Neipris, MD, Staff Writer
Created on 10/18/2005
Updated on 09/27/2010
Sources:
  • American Lung Association. Primary pulmonary hypertension: Symptoms, diagnosis and treatment.
  • American Society of Transplantation. Getting a new lung.
  • American College of Chest Physicians. A guide to lung transplantation.
  • American Lung Association. Living with COPD: Surgery.
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