Lung transplant is surgery to replace one or both diseased lungs with healthy lungs from a human donor.
Solid organ transplant - lung
The new lung or lungs are usually donated by someone under age 65 who is brain-dead but is still on life-support. The donor tissue must be matched as closely as possible to your tissue type to reduce the odds that your body will reject the transplanted lung.
Lungs can also be given by living donors. Two or more people are needed. Each person donates a segment (lobe) of their lung to form an entire lung for the person who is receiving it.
During lung transplant surgery, you are asleep and pain-free (under general anesthesia). A surgical cut is made in the chest. Lung transplant surgery is done with the use of a heart-lung machine, which does the work of your heart while your heart is stopped for the surgery.
After the cut is made, the major steps during lung transplant surgery include:
Sometimes heart and lung transplants are done at the same time (heart-lung transplant) if the heart is also diseased.
A lung transplant is usually the last-resort treatment for lung failure. Lung transplants may be recommended for patients under age 65 who have severe lung disease. Some examples of diseases that may require a lung transplant are:
Lung transplant may NOT be done for patients who:
The doctor may recommend against a heart transplant if there is concern that you will not be able to keep up with the many hospital and doctor's visits, tests, and medications needed to keep the new heart healthy.
Risks from any anesthesia are:
Risks from any surgery are:
Other risks of transplant include:
Risks of lung transplant include:
Before the procedure, your doctor will determine whether you are a good candidate by doing the following tests:
If your transplant team believes that you are a good candidate for lung transplantation, you will be put on a national waiting list. Your place on the waiting list is based on a number of factors, including:
The amount of time you spend on a waiting list usually does not determine how soon you get a lung, except possibly with children. Waiting time is often at least 2 - 3 years.
While you are waiting for a new lung, follow these guidelines:
Before the procedure, always tell your doctor or nurse:
Do not eat or drink anything after midnight the night before your surgery. Take only the drugs that your doctor told you to take with a small sip of water.
You should expect to stay in the hospital for 7 - 21 days after a lung transplant. You will likely spend time in the intensive care unit (ICU) right after surgery. Most centers that perform lung transplants have standard ways of treating and managing lung transplant patients.
During your hospital stay, you will:
The recovery period is about 6 months. Often, your transplant team will ask you to stay close to the hospital for the first 3 months. You will need to have regular check-ups with blood tests and x-rays for many years.
A lung transplant is a major procedure that is performed for patients with life-threatening lung disease or damage.
Around four out of five people are still alive 1 year after the transplant. Around two out of five transplant recipients are alive at 5 years. Outcomes are similar for single and double lung transplants. The highest risk of death is during the first year, mainly from problems such as rejection.
Fighting rejection is an ongoing process. The body's immune system considers the transplanted organ as an invader (much like an infection) and may attack it.
To prevent rejection, organ transplant patients must take anti-rejection (immunosuppression) drugs (such as cyclosporine and corticosteroids). These drugs suppress the body's immune response and reduce the chance of rejection. As a result, however, these drugs also reduce the body's natural ability to fight off infections.
By 5 years after a lung transplant, at least one in five people develop cancers or have problems with the heart. These two conditions cause most deaths at 5 years.
For most people, the quality of life is improved after a lung transplant. They have better exercise endurance and are able to do more on a daily basis.
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Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.