A lung transplant is an effective treatment for disease that has destroyed most of the lungs’ function. For people with severe lung disease, a transplant can bring back easier breathing and provide years of life. However, lung transplant surgery has major risks and complications are common.
Who May Need a Lung Transplant?
Most people with severe, end-stage lung disease can be considered for a lung transplant. The procedure should be considered when someone seems likely to die without the surgery and no other options are available. A lung transplant can also be considered in people whose lung disease is so severe that they can no longer enjoy life.
The most common lung diseases for which people undergo lung transplant are:
Among people with these conditions, lung transplant reasons can vary. For example, in emphysema, lung tissue is destroyed by smoking; in idiopathic pulmonary fibrosis, scar tissue replaces healthy lung.
Lung transplant centers may hesitate when considering people over age 60 or 65 for lung transplant.
Preparing for a Lung Transplant
The evaluation process for a lung transplant is usually long and complicated. First, a doctor refers a patient to a regional transplant center. At the transplant center, doctors, psychologists, social workers, and other staff meet with the person to gather information. This may take place on several visits occurring over many weeks or months.
Besides the patient’s lung condition, the team considers the person’s family and social support, financial situation, psychological makeup, and any other medical conditions. Numerous tests are performed during a lung transplant evaluation, which can include:
- Pulmonary function tests
- Cardiac stress test
- Coronary artery catheterization
- Bone mineral density test
- Chest X-ray
- Computed tomography (CT scan) of the chest
- Blood tests for kidney function and liver function, and a complete blood count (CBC)
- Blood type and antibodies present in the blood, for matching against potential organ donors
Doctors usually won't recommend a lung transplant if these conditions are present: significant heart, liver, or kidney disease; alcohol or drug abuse; ongoing infections; or cancer. Also, anyone who continues to smoke cannot receive a lung transplant.
Going on the Lung Transplant List
After testing and interviews have been completed and it’s concluded the patient is a good candidate for a lung transplant, he or she will be listed on regional and national organ recipient lists. A person’s place on the list is determined by the Lung Allocation Score, a complicated calculation that tries to predict two things:
- How long a patient is likely to live without a lung transplant
- How long a patient would be expected to live after receiving a lung transplant
People with higher scores are considered first when organ donors’ lungs become available.