Lung Transplant

Lung Transplant

Definition

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

Reasons for Procedure

A transplant is done if the lung injury or disease cannot be cured. It may be considered at the end stage of life-threatening diseases such as:

Normal vs. Emphysemic Lung

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Possible Complications

Problems from the procedure are rare, but all have some risk. Your doctor will talk to you about possible problems, like:

  • Infection
  • Bleeding
  • Blockage of the blood vessels to the new lung(s)
  • Blockage of the airways
  • Fluid in the lung
  • Blood clots
  • Rejection of the donor lung (your body's immune system attacks the new lungs)
  • Anesthesia-related problems
  • Death
  • Conditions related to taking immunosuppressant drugs

Lifelong medicine will be needed after a transplant. The medicine will lower the immune system. It will stop the body from attacking the new organ. This can lead to complications such as:

What to Expect

Prior to Procedure

A long approval process will be done before the surgery. It will make sure you are ready and able to have a transplant. Tests will be reviewed to make sure the heart and lungs are strong enough for surgery.

After an approval comes a waiting list. There is a shortage of donors. Donors are matched carefully for size, tissue type, and other factors. A healthy family member can donate part of a lung. There may be a long wait.

You will need to be easily reached at all times. There may not be much notice before surgery. It is important to have a plan in place. A hospital stay will be needed during recovery.

Anesthesia

General anesthesia will be used. It will keep you asleep during the surgery. It will also block pain.

Description of the Procedure

An incision will be made on the chest. For a single lung transplant, it will be on your side below your underarm. For a double lung transplant, it will be across the lower chest.

A heart-lung machine will be placed. It will take over the work of your lungs and heart during surgery. It will keep oxygen flowing to your body during surgery. The doctor will remove a small area of ribs. This will allow access to your lung. The old lung will be cut away from the blood vessels and airways. The new lung will then be placed. The doctor will attach the blood vessels and airways to the new lung. The heart-lung machine will be removed. The doctor will make sure the lung is working well before the chest wall is closed.

How Long Will It Take?

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

Immediately After Procedure

Recovery will start in the intensive care unit (ICU). Staff will make sure the lung is working well. The stay may last for 2 to 3 days.

  • The care team will monitor your pulse, breathing, and other vital signs.
  • A breathing tube and ventilator may be needed at first. It will be removed when you are able to breathe on your own.
  • Medicine will be started to keep the body from rejecting the new lung

How Much Will It Hurt?

There will be pain in chest for the first few weeks. Medicine will help to ease pain.

Average Hospital Stay

The usual length of stay is 7 to 10 days. The stay may be longer if problems arise.

Post-procedure Care

It will take about 6 months to recover from a lung transplant. Help may be needed at home during recovery. Ongoing treatment and monitoring may include:

  • Tracking your temperature, weight, and blood pressure.
  • Pulmonary function tests at home or medical center
  • Regular doctor visits for:
    • Blood tests
    • Lung biopsies at regular intervals to check for lung rejection
    • X-rays and EKGs

Call Your Doctor

It is important for you to monitor your recovery. Alert your care team to any problems right away. If any of the following occur, call your doctor:

  • Breathing problems
  • 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 or burning
  • Sudden headache or feeling faint
  • Changes in blood pressure or weight
  • Burning, 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 emergency medical services right away.

RESOURCES:

American Lung Association
http://www.lung.org
United Network for Organ Sharing
http://www.transplantliving.org

CANADIAN RESOURCES:

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

References:

Explore lung transplant. National Heart, Lung, and Blood Institute website. Available at:
...(Click grey area to select URL)
Accessed August 29, 2018.
Lung Transplantation. EBSCO Nursing Reference Center website. Available at:
...(Click grey area to select URL)
Updated November 23, 2018. Accessed May 10, 2019.
Lung transplant - procedure and perioperative management. EBSCO DynaMed website. Available at: https://www.dynamed.com/topics/dmp~AN~T922344/Lung-transplant-procedure-and-perioperative-management. Lat reviewed April 19, 2019. Accessed May 10, 2019.
Lung transplant Surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/lung-transplant-surgery. Published May 12, 2017. Accessed August 29, 2018.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 5/10/2019

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