Patient education: Lung transplant (The Basics)

What is a lung transplant? — A lung transplant is a type of surgery in which a doctor replaces 1 or both of your diseased lungs with healthy lungs (figure 1).

There are different types of lung transplant. Doctors can replace both lungs, which is called a "bilateral lung transplant." This type of surgery is done most often. Doctors can also replace only 1 lung, which is called a "single lung transplant."

Other types of lung transplant are less common. This includes getting a part of a lung from a family member or friend. In rare cases, people get a bilateral lung transplant and a heart transplant at the same time.

The type of lung transplant you have depends on your lung disease and individual situation.

Why might I have a lung transplant? — A lung transplant is done to treat severe lung disease. Different lung conditions can lead to severe lung disease, including:

●Chronic obstructive pulmonary disease, called "COPD" for short

●Pulmonary fibrosis

●Cystic fibrosis

●Alpha-1 antitrypsin deficiency

●Pulmonary hypertension

Before you have a lung transplant, your doctor will try all other treatments first. Your doctor will recommend a lung transplant only if all other treatments fail and your lung disease is so severe it could be fatal in the next 1 to 2 years.

What happens before I can get a lung transplant? — Before you can get a lung transplant, you need to go through a number of steps.

Your doctor will send you to a lung transplant center (a hospital that does lung transplants). At the transplant center, you will have exams and tests. You and your family will also talk with different doctors. They will ask about your:

●Other medical conditions and the medicines you take

●Lifestyle (for example, whether you smoke, drink alcohol, or use illegal drugs)

●Family and other support system

Not everyone who is sent to a lung transplant center will get a transplant. To be considered for a lung transplant, you need to meet certain conditions. For example, you need to:

●Have very severe lung disease that hasn't gotten better with other treatments

●Not have certain infections or medical conditions, such as cancer

●Agree to not smoke, drink alcohol, or use illegal drugs, which can harm your new lungs

●Agree to take medicines for the rest of your life after surgery

If you meet all of these conditions, you will be put on a waiting list for new lungs. An organization called "UNOS" keeps track of everyone on the list. UNOS tries to give lungs to the sickest people first. Your doctors will let UNOS know if your disease gets worse.

What can I do on my own to prepare for a lung transplant? — You can stay as healthy as possible. To stay as healthy as possible, you can:

●Get regular exercise – This will help keep your breathing and other muscles strong. Most people need to do a "pulmonary rehab" program. In pulmonary rehab, you will learn exercises and ways to breathe.

●Eat a healthy diet – This will keep your body strong. To help your surgery and recovery go more smoothly, you should also keep your body at a healthy weight.

●Get the shots (vaccines) your doctor recommends – This includes a yearly flu shot. It also includes a shot called the pneumococcal vaccine. These shots can help prevent infections that can further damage your lungs.

●Stop smoking – You will need to have stopped smoking for a certain amount of time before you can get on the UNOS list.

What happens when lungs become available? — When lungs become available, UNOS chooses the person who is the best match for them. People who are waiting for a transplant need to carry a cell phone or pager at all times so that they can be reached quickly.

When you get called for your lung transplant, you will need to get to the hospital quickly.

What happens after a lung transplant? — After surgery, most people stay in the hospital for a few weeks before going home. In the hospital and at home, your doctors will monitor you and do tests to make sure your new lungs are working correctly. Tests usually include breathing tests, chest X-rays, blood tests, and a procedure called bronchoscopy. During bronchoscopy, a doctor uses a thin tube with a camera and light on the end (called a "bronchoscope") to look in your airways.

After a lung transplant, you will need to take medicines called "anti-rejection medicines." These medicines prevent your body's immune (infection-fighting) system from rejecting the new lungs. But they also make it difficult for your immune system to fight off infections. Because of this, you will also need to take antibiotics to prevent infections. It's also important to tell your doctor or nurse right away if you get a fever.

The specific anti-rejection medicines and antibiotics you take can change over time. But you will need to take anti-rejection medicines for the rest of your life.

What problems can people have after a lung transplant? — In many cases, people do well after surgery. They can go to work and be active. But a lung transplant is major surgery. Some people have problems after a lung transplant. Some people do not even survive the surgery. The problems that can happen after a lung transplant can happen right after the surgery or a few years later. They include:

●Rejection of the new lungs – Even though people take anti-rejection medicines, their body might still reject and attack the new lungs.

●A narrowing or blockage in an airway

●A blood clot in the lungs

●Infections in the lungs

●Side effects from the anti-rejection medicines – These medicines can increase your chance of getting infections and certain types of cancer. They also can cause nausea, vomiting, diarrhea, headache, and kidney or liver problems.

●The original lung disease returning

More on this topic

Patient education: Cystic fibrosis (The Basics)
Patient education: Chronic obstructive pulmonary disease (COPD) (The Basics)
Patient education: Shortness of breath (dyspnea) (The Basics)
Patient education: Idiopathic pulmonary fibrosis (The Basics)
Patient education: Pulmonary hypertension (The Basics)
Patient education: Breathing tests (The Basics)
Patient education: Coping with high drug prices (The Basics)
Patient education: Lymphangioleiomyomatosis (The Basics)

Patient education: Chronic obstructive pulmonary disease (COPD) (Beyond the Basics)
Patient education: Shortness of breath (dyspnea) (Beyond the Basics)