Lung transplant

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.

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.

Several tests can help your doctor and you see how well a lung transplant might work. These tests include lung function tests, arterial blood gas tests, and exercise capacity.

A lung transplant can give a person with severe lung damage from CF a better chance of survival. It can help them feel better and have more energy. And it may allow them to work, return to school, or reach other personal goals.

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.

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.