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Lung Transplant

What Happens During a Lung Transplant

When a compatible donor’s lungs become available, the transplant candidate will be called urgently to the transplant center to prepare for the surgery. Members of the surgical team travel to examine the deceased donor’s lungs to make sure they are suitable for transplant. If they are, surgery on the recipient begins immediately, while the lungs are in transit to the center.

Surgeons may perform either a single lung transplant or a double lung transplant. There are advantages and disadvantages to each option, and the choice varies with the recipient’s lung disease and other factors.

A surgeon will make a large incision in the chest during a lung transplant. The incision varies by the type of lung transplant:

  • An incision on one side of the chest only (for a single lung transplant)
  • An incision across the entire width of the front of the chest, or an incision on either side (for a double lung transplant)

Complete unconsciousness is maintained with general anesthesia during the surgery. Some people receiving a lung transplant will need to go on cardiopulmonary bypass during the surgery. While on bypass, the blood is pumped and enriched with oxygen by a machine, rather than by the heart and lungs.

After a Lung Transplant

The time to full recovery after a lung transplant varies widely between people. Some people may leave the hospital within a week. However, it’s not that unusual to be in the hospital for two weeks or longer after lung transplant surgery.

The weeks after lung transplant are busy, filled with activities intended to ensure long-term success. These include:

  • Regular physical therapy and rehabilitation exercises
  • Education sessions to learn a complicated new lifelong medication plan
  • Frequent visits to the doctor
  • Regular tests of lung function, chest X-rays, blood tests, and procedures like bronchoscopy

Many transplant centers offer temporary housing nearby for patients and their families to make the frequent visits easier.

Lung Transplant Prognosis

A lung transplant can take away breathlessness and make possible an active lifestyle that can last for years. For many people, a lung transplant is nothing less than lifesaving.

After recovering from lung transplant surgery, more than 80% of people say they have no limitations on their physical activity. Among people surviving five years or more, up to 40% continue to work at least part time.

However, eventual complications after lung transplant are inevitable. The immune system’s rejection of the new lungs can be slowed, but not stopped entirely. Also, the necessary powerful immune-suppressing drugs have unavoidable side effects, including diabetes, kidney damage, and vulnerability to infections.

For these reasons, long-term survival after a lung transplant is not as promising as it is after other organ transplants, like kidney or liver.

Still, more than 80% of people survive at least one year after lung transplant. After three years, between 55% and 70% of those receiving lung transplants are alive. Age at the time of transplant is the most important factor influencing lung transplant survival.

 

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WebMD Medical Reference

Reviewed by James E. Gerace, MD on July 02, 2013

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