What Is a Lung Transplant?
A lung transplant is surgery that replaces a diseased or failing lung with a healthy, donor lung.
According to data from the Organ Procurement and Transplantation Network, there have been more than 23,815 lung transplants in the U.S. since 1988. The majority of those surgeries were in patients 50 to 64 years old.
The survival rate of lung transplant surgeries continues to improve. The one-year survival rate is over 80 percent. The five-year survival rate is 50 percent. Twenty years ago, those numbers were much lower (OPTN/SRTR, 2011).
Survival rates vary by facility. When researching where to have your surgery, it’s important to inquire about their survival rates.
Why a Lung Transplant Is Done
A lung transplant is considered the last option for treating lung failure. Other treatments and lifestyle changes will almost always be tried first.
Conditions that may damage the lungs enough to require a transplant include:
- chronic obstructive pulmonary disease (COPD)
- cystic fibrosis
- pulmonary fibrosis
- pulmonary hypertension
The Risks of a Lung Transplant
A lung transplant is major surgery. It comes with many risks. Before the surgery, your doctor should discuss with you whether the dangers of the procedure outweigh the benefits. You should also talk about what you can do to reduce your risks.
The major risk of a lung transplant is organ rejection. This happens when your immune system attacks the donor lung as if it were a disease. Severe rejection could lead to a failure of the donated lung.
Less serious complications can arise from the drugs used to prevent rejection. These are called immunosuppressants. They work by lowering your immune response, making it less likely that your body will attack the new, “foreign” lung. Immunosuppresants may make you more likely to catch other infections, however, as your body’s “guard” will be lowered.
Other of lung transplant surgery include (Mayo Clinic):
- bleeding and blood clots
- cancer and malignancies due to immunosuppressants
- kidney damage
- stomach problems
- thinning of the bones (osteoporosis)
It is important to follow your doctor’s instructions before and after your surgery. This can help decrease your risks. Instructions will include making healthy lifestyle choices—such as not smoking and adopting a healthy diet—and not missing any doses of medications.
How to Prepare for a Lung Transplant
The emotional toll of waiting for a donor lung can be difficult.
Once you’ve undergone the necessary tests and met qualifying criteria, you’ll be placed on a waiting list for a donor lung. Your waiting time on the list depends on the following:
- availability of a matching lung
- blood type
- geographic distance between donor and recipient
- the severity of your condition
- the size of the donor lung
- your overall health
You will undergo include numerous laboratory and imaging tests. You may also undergo emotional and financial counseling. The doctors need to make sure you are fully prepared for the after-effects of the procedure.
Your doctor will give you complete instructions on how to best prepare for your surgery. If you’re waiting on a donor lung, it’s good to have your bags packed well in advance. The notice that an organ is available could come at any time. Also, make sure to keep all of your contact information up-to-date at the hospital. They need to be able to contact you when a donor lung is available.
You will be notified when a donor lung is available. You’ll be instructed to report to the transplant facility immediately.
How a Lung Transplant Is Performed
When you and your donor lung arrive at the hospital, you’ll be prepared for surgery. This includes changing into a hospital gown, receiving an IV, and undergoing general anesthesia. This will put you into an induced sleep. You will awaken in a recovery room after your new lung is in place.
Your surgical team will insert a tube into your windpipe to help you breathe. Another tube will be inserted into your nose. It will drain your stomach contents. A catheter will be used to keep your bladder empty.
You may also be put on a heart-lung machine. This device pumps your blood and oxygenates your blood for you during your surgery.
During the surgery, your surgeon will make a large incision in your chest. Through this incision, your old lung will be removed. Your new lung will be connected to your main airway and blood vessels.
When the new lung is working properly, the incision will be closed. You will be moved to an intensive care unit (ICU) to recover.
A typical single-lung procedure can take between four and eight hours. A double-lung transfer can take up to 12 hours (NHLBI, 2011).
Following Up After a Lung Transplant
You can expect to remain in the ICU for a few days after the procedure. Your vital signs will need to be closely monitored. You’ll be hooked up to a mechanical ventilator to help you breathe. Tubes will also be connected to your chest to drain any fluid buildup.
Your entire stay at the hospital could be up to three weeks—but could be shorter. How long depends on how well you recover.
Over the next three months, you’ll have regular appointments with your lung transplant team. They will monitor any signs of infection, rejection, or other problems. You will be required to live close to the transplant center.
Before you leave the hospital, you will be given instructions on how to care for your surgical wound. You will also be told about any restrictions to follow and given medication. Most likely, it will include one or more types of immunosuppressant, such as:
- mycophenolate mofetil
Immunosuppressants are important after your transplant. They help prevent your body from attacking your new lung. However, they leave you open to infection and other problems. Make sure to talk to your doctor about all the side effects you can expect.
You may also be given:
- antifungal medication
- antiviral medication
- anti-ulcer medication
The Mayo Clinic reports that the first year after a transplant is the most critical. This is when the major complications—infection and rejection—are most common. You can minimize these risks by following your lung transplant team’s instructions and immediately reporting any complications (Mayo Clinic, 2010).