What is lung transplant?

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Lung transplant: Overview

A lung transplant is surgery to remove one or both of your diseased lungs and give you one or two new healthy ones. The new lung may come from a deceased person, or part of a lung may come from a living donor.

Your body may be able to work with only one healthy lung. Many people get both lungs transplanted. Some people only get one lung transplanted. This may be done if a person has one lung that is more diseased than the other.

During the surgery, the doctor makes a cut (incision) in your chest. The doctor will cut off the blood vessels and airways that are connected to your damaged lung. Your old lung will be replaced with the healthy donor lung. Then the doctor will reattach the blood vessels and airways to your new lung. If both lungs are being transplanted, they will be removed and then reattached one at a time. The doctor closes the incision with stitches that may dissolve on their own. Or the doctor may use staples that are removed about 1 to 3 weeks after surgery. The incision will leave a scar that will fade with time.

After surgery, the new lung should start to work right away. This can help you breathe more easily.

You will probably spend 1 to 3 weeks in the hospital. But it may take 2 to 3 months or longer for your energy to fully return.

How can you care for yourself after a lung transplant?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 4 to 6 weeks.
  • For 4 to 6 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
  • Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
  • Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
  • Ask your doctor when you can drive again.
  • Most people are able to return to work about 2 to 3 months after surgery. It depends on the type of work you do and how you feel.
  • You may take showers. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • Follow your doctor's instructions about what to eat after your surgery. You will probably be able to eat your usual diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • Check with your doctor before you drink alcohol. Alcohol can cause problems with some of the medicines used to prevent organ rejection.
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Take your anti-rejection medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, take an over-the-counter medicine that your doctor recommends. Read and follow all instructions on the label.
    • Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

How well does a lung transplant work?

A lung transplant can increase how long a person with severe lung damage is expected to live. It can help you feel better and have more energy. And it may help you be more able to do things like working, going to school, or other activities.

How successful a lung transplant is may depend on:

  • Your overall health. After the transplant, it's important to keep a healthy lifestyle, such as eating healthy foods and being active. Don't smoke. And try to avoid being around others who smoke. Try to limit alcohol.
  • Whether you take your medicines as prescribed.
  • Finding and treating organ rejection early. This makes it more likely that your lungs will stay healthy. That's why it's important to go to follow-up appointments and get tests.
  • The disease that caused your lungs to fail.

How do you prepare for a lung transplant?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What are the risks of a lung transplant?

Like any surgery, a lung transplant has some risks. They include:

  • Organ rejection. Your body's immune system tries to attack the transplanted organ by rejecting it. It happens because the transplanted organ doesn't match your own tissue exactly.
  • Problems such as bleeding during and after the surgery.
  • Infection. The medicines you'll need to take to help your body accept the new lungs can also make it harder for your body to fight infection.
  • Certain cancers, such as skin cancer. This risk increases because anti-rejection medicines can also prevent the body from attacking cancer cells.

Lung Transplant

Picture of lung transplant

For a lung transplant, the recipient's diseased lung is removed and replaced with the donated lung.

After lung transplant: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe pain in your chest or belly.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You are sick to your stomach or cannot keep down fluids or your anti-rejection medicines.
  • You have a fever, chills, or body aches.
  • You have loose stitches, or your incision comes open.
  • You are bleeding from the incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have trouble passing urine or stool, especially if you have pain or swelling in your lower belly.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have any problems with your anti-rejection medicine.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not have a bowel movement after taking a laxative.

What can you expect as you recover from a lung transplant?

You'll take medicines to prevent your immune system from rejecting the new lung or lungs. This helps make it more likely that your body will accept the new lungs.

After you leave the hospital, you'll have checkups and blood tests to see how well your lungs are working. You'll have these checkups less often over time. You'll also need to have tests to check for certain kinds of cancer.

It's important to follow a healthy lifestyle to help keep your lungs healthy. This will include eating healthy foods, avoiding smoking, and staying active. You may have to do things to reduce your risk of infection. For instance, you may need to limit visitors while you recover. And you may need to avoid large crowds where you could be exposed to a virus like the flu.

After a transplant, many people say they feel better than they have in years. Over time, you may find that you can do more activities than you did before.

Getting support

Having good support is important throughout the process of getting a transplant. Waiting for your transplant can be hard emotionally. After your surgery, you may have concerns about your health and the new organs you received. You'll also have a lot to manage, like taking new medicines and going to follow-up visits.

Getting support from others, such as friends and family, can help during this time. A counselor can help you learn to cope with stress and other emotions before and after your procedure.

Many people who have an organ transplant feel anxious or depressed. Talk to your doctor if you think you may be depressed. Depression can be treated with medicines and counseling.

After lung transplant: Overview

A lung transplant is surgery to remove your diseased lung and give you a healthy lung from a person who has died. Most people get one new lung. Your body will be able to work with just one healthy lung. But in some cases, a person may get two new lungs.

Your side and chest will be sore for the first 1 to 2 weeks after surgery. You also may have some numbness around the cut (incision) the doctor made. You may feel tired while you are healing. It can take 2 to 3 months for your energy to fully return. Your doctor may advise you to work with a respiratory therapist to make your new lung stronger.

After the transplant, you must take medicine to keep your body from rejecting the new lung. You will need to take this antirejection medicine every day for the rest of your life. These medicines have side effects. One side effect is that your body may be less able to fight infections. It is important that you take steps to avoid infections. Stay away from crowds of people and anyone who might have an infection or an illness such as a cold or the flu.

Having an organ transplant can bring up many emotions. You may feel grateful and happy. But you also may feel guilty or depressed. Seek out family, friends, and counselors for support. If you think you are depressed, ask your doctor for help. Treatment can help you feel better.

What happens on the day of your lung transplant?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 3 to 6 hours.
  • You will have a tube down your throat for a while. It will help you breathe.
  • You will probably have one or two tubes coming out of your chest. These tubes drain fluid and air. They will be removed before you go home.

Why is a lung transplant done?

A lung transplant may be done when:

  • Your lung or lungs are diseased or damaged (usually from a chronic condition) and aren't able to work as they should.
  • Other treatments haven't worked to improve your lung function.

Conditions that may result in a lung transplant include:

  • Interstitial (say "in-ter-STIH-shul") lung disease, such as pulmonary fibrosis.
  • Chronic obstructive pulmonary disease (COPD), including emphysema.
  • Cystic fibrosis.
  • Alpha-1 antitrypsin deficiency.
  • Pulmonary hypertension.
  • Sarcoidosis.

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