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by EBSCO Medical Review Board

Definition

A lung transplant removes a diseased or damaged lung and replaces it with a healthy one from a donor. One or both lungs may be replaced.

Reasons for Procedure

A lung transplant is done to treat a lung that is not working and cannot be treated. This may be caused by problems such as:

Normal vs. Emphysemic Lung
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Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Blockage of the blood vessels to the new lung(s)
  • Blockage of the airways
  • Fluid in the lung
  • Rejection of the new lung
  • Death

Things that may raise the risk of problems are:

Lifelong medicine will be needed to suppress the immune system to lower the risk of the body rejecting the lung. This can lead to problems, such as:

What to Expect

Prior to Procedure

A healthy family member can donate part of a lung. If that is not an option, you may be on a transplant list for some time. You may need to carry a cell phone with you at all times. This will allow the transplant team to reach you if a lung becomes available.

The surgical team will meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging a ride to and from surgery
  • Specialists you may need to see
  • Tests that will need to be done before surgery, such as imaging and heart function tests

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure

A cut will be made on the chest. It will be on one side below the underarm for a single lung transplant. It will be across the lower chest for a double lung transplant.

A heart-lung machine will be used to take over the work of the those organs. It will keep oxygen flowing to the body. A small area of ribs will be removed to access the lung. The damaged lung will be cut from the blood vessels and airways. The new lung will put in place and attached to the blood vessels and airways. The heart-lung machine will be removed. The cut will be closed with stitches and covered with a bandage.

Immediately After Procedure

Recovery will start in the intensive care unit (ICU). Staff will make sure the lung is working well.

How Long Will It Take?

  • 4 to 8 hours for a single lung transplant
  • 6 to 12 hours for a double lung transplant

Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and swelling are common in the first few weeks after surgery. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 7 to 10 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

  • Give you pain medicine
  • Start you on medicine to suppress the immune system and lower the risk of the body rejecting the lung
  • Test your lung function
  • Remove the breathing tube and ventilator when you are able to breathe on your own
  • Have you wear special stockings to promote blood flow and lower the risk of blood clots

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your cuts covered

During your stay, you can also take steps to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your cuts

It will take a few weeks for the cut to fully heal. Full recovery will take about six months. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay your return to work.

Problems to Look Out For

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Pain that you cannot control with medicine
  • Redness, swelling, excessive bleeding, or any discharge from the cut
  • Lasting nausea or vomiting
  • Severe headache
  • Lightheadedness or fainting
  • Pain or swelling in the feet, calves, or legs
  • Problems passing urine or stool
  • Coughing up blood or phlegm

Call for emergency help right away if you have:

  • Problems breathing
  • Cough, shortness of breath, or chest pain
  • Blue or gray skin color

If you think you have an emergency, call for medical help right away.

RESOURCES

American Lung Association  https://www.lung.org 

United Network for Organ Sharing  https://www.transplantliving.org 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

The Lung Association  https://www.lung.ca 

References

Lung disease treatments. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/lung-treatments. Accessed April 14, 2022.

Lung transplant overview. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/lung-transplant-overview. Accessed April 14, 2022.

Lung transplant - procedure and perioperative management. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/lung-transplant-procedure-and-perioperative-management. Accessed April 14, 2022.

Lung transplant Surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/4378-lung-transplant-surgery. Accessed April 14, 2022.

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