Definition

This is a surgery to remove severely diseased and damaged lungs. They are replaced with healthy lungs from a deceased donor. One or both lungs may be transplanted. In some cases, a heart transplant is done at the same time. In that case, the procedure is called a heart-lung transplant .

Reasons for Procedure

A lung transplant is done to treat irreversible, life-threatening lung disease, such as:

    
  • End-stage chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema
  • Cystic fibrosis
  • Pulmonary hypertension
  • Alpha-1 antitrypsin deficiency (a genetic disorder)
  • Sarcoidosis
  • Severe scarring or inflammation of the bronchioles (smallest airways)
  • Normal vs. Emphysemic Lung

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    Possible Complications

    If you are planning to have a lung transplant, your doctor will review a list of possible complications, which may include:

        
  • Infection
  • Bleeding
  • Rejection of the donor lung (your body's immune system attacks the new lungs)
  • Conditions related to taking immunosuppressant drugs     
  • Infection
  • Cancer
  • Diabetes
  • Kidney damage
  • Osteoporosis
  • Anesthesia-related problems
  • Death
  • What to Expect

    Prior to Procedure

    Before you have a lung transplant, you will go through an intensive evaluation. This is done to determine if you are a good candidate for this surgery. During the evaluation, which often requires a hospital stay, you will have some or all of the following tests:

        
  • Physical exam
  • Blood tests
  • Tissue typing
  • Electrocardiogram (EKG)
  • Chest CT scan —to look at the lung structure
  • Echocardiogram —to examine the size, shape, and motion of the heart
  • Pulmonary function tests —to measure the function of the lungs
  • Ventilation-perfusion lung scan—a test that examines the movement of blood and air through the lungs
  • Cardiac catheterization —to detect problems with the heart and its blood supply
  • If you are a good candidate for a transplant, you will be put on a waiting list. There is a shortage of donors. You may need to wait a long time. You will need to carry a cell phone with you at all times. This will allow the transplant team to reach you if a donor lung becomes available. Donors are matched carefully for size, tissue type, and other factors. In some cases, a healthy family member can donate a lung if you only need a single transplant.

    Leading up to your procedure:

        
  • Arrange for a ride to the hospital.
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • Your doctor may ask you to stop taking some medications up to one week before the procedure.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.
  • Anesthesia

    General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

    Description of the Procedure

    For a single lung transplant, the doctor will make an incision on your side. It will be about six inches below your underarm. For a double lung transplant, the doctor will make an incision across the lower chest.

    You will be put on a ventilator and a heart-lung machine. This machine will take over the functions of the heart and lungs during surgery. Next, the doctor will remove a small section of rib. This will allow access to your lung. The old lung will be cut away from the main blood vessel and bronchus (large airway). The new lung will then be inserted. The doctor will attach the blood vessels and bronchus to the new lung.

    Immediately After Procedure

    You will stay in the intensive care unit (ICU) for 2-3 days. The doctors and nurses pulse, breathing, and vital functions.

    How Long Will It Take?

        
  • 4-8 hours for a single lung transplant
  • 6-12 hours for a double lung transplant
  • How Much Will It Hurt?

    Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

    Average Hospital Stay

    This surgery is done in a hospital setting. The usual length of stay is 7-10 days. Your doctor may choose to keep you longer if you shows signs of rejecting the new lungs or have other problems.

    Post-procedure Care

    Arrange for help at home until you can manage on your own. There will be some adjustments that you will have to make because of the transplant. These include:

        
  • Taking immunosuppressive drugs to prevent your body from rejecting the new lung
  • Lung biopsies at regular intervals to check for lung rejection
  • Blood tests
  • X-rays and EKGs
  • Measuring and tracking your temperature, weight, and blood pressure
  • Lifestyle changes, such as:     
  • Avoiding exposure to tobacco smoke and other toxic elements
  • Exercising regularly to help maintain lung capacity
  • Limiting your intake of salt, foods high in fat and cholesterol, sweets, and alcohol
  • It will take about 6 months to recover from a lung transplant.

    Call Your Doctor

    It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

        
  • Signs of rejection including fever, chills, achiness like the flu, shortness of breath, decreased ability to exercise
  • Signs of infection including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Persistent nausea and/or vomiting
  • Pain that you can't control with the medications you were given
  • Coughing up blood
  • Waking up at night due to being short of breath
  • Increase in phlegm production
  • Pain, burningSudden headache or feeling faint
  • Changes in blood pressure or weight
  • , urgency, frequency of urination, or persistent bleeding in the urine
  • Call for emergency medical services right away if any of the following occurs:

        
  • Fast breathing or trouble breathing
  • Cough, shortness of breath, or chest pain
  • Chest pain that is new or worse
  • Blue or gray skin color
  • If you think you have an emergency, call for medical help right away.