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A lung transplant is a surgical procedure to replace a diseased or failing lung with a healthy lung, usually from a deceased donor. A lung transplant is reserved for people who have tried medications or other treatments, but their conditions haven’t sufficiently improved.

Depending on your medical condition, a lung transplant may involve replacing one of your lungs or both of them. In some situations, the lungs may be transplanted along with a donor heart.

While a lung transplant is a major operation that can involve many complications, it can greatly improve your health and quality of life.

When faced with a decision about having a lung transplant, know what to expect of the lung transplant process, the surgery itself, potential risks and follow-up care.

Why it’s done

Unhealthy or damaged lungs can make it difficult for your body to get the oxygen it needs to survive. A variety of diseases and conditions can damage your lungs and keep them from functioning effectively. Some of the more common causes include:

• Chronic obstructive pulmonary disease (COPD), including emphysema
• Scarring of the lungs (pulmonary fibrosis)
• Cystic fibrosis
• High blood pressure in the lungs (pulmonary hypertension)

Lung damage can often be treated with medication or with special breathing devices. But when these measures no longer help or your lung function becomes life-threatening, your health care provider might suggest a single-lung transplant or a double-lung transplant.

Some people with coronary artery disease may need a procedure to restore blood flow to a blocked or narrowed artery in the heart, in addition to a lung transplant. In some cases, people with serious heart and lung conditions may need a combined heart-lung transplant.

Factors that may affect your eligibility for a lung transplant

A lung transplant isn’t the right treatment for everyone. Certain factors may mean you’re not a good candidate for a lung transplant. While each case is considered individually by a transplant center, a lung transplant may not be appropriate if you:

• Have an active infection
• Have a recent personal medical history of cancer
• Have serious diseases such as kidney, liver or heart diseases
• Are unwilling or unable to make lifestyle changes necessary to keep your donor lung healthy, such as not drinking alcohol or not smoking
• Do not have a supportive network of family and friends

Risks

Complications associated with a lung transplant can be serious and sometimes fatal. Major risks include rejection and infection.

Risk of rejection

Your immune system defends your body against foreign substances. Even with the best possible match between you and the donor, your immune system will try to attack and reject your new lung or lungs. The risk of rejection is highest soon after the lung transplant and is reduced over time.

Your drug regimen after transplant includes medications to suppress your immune system (immunosuppressant medications) in an effort to prevent organ rejection. You take these anti-rejection drugs for the rest of your life.

Side effects of anti-rejection drugs

Anti-rejection drugs may cause noticeable side effects, including:

• Weight gain
• Unwanted hair growth or hair loss
• High cholesterol
• Stomach problems

Some anti-rejection medications can also increase your risk of developing new conditions or aggravating existing conditions, such as:

• Diabetes
• Kidney damage
• Osteoporosis
• Cancer
• High blood pressure (hypertension)

Risk of infection

Anti-rejection drugs suppress your immune system, making your body more susceptible to infections, particularly in your lungs.

To help prevent infections, your doctor may recommend that you:

• Wash your hands regularly
• Brush your teeth and gums regularly
• Avoid contact with pets and avoid cleaning pet areas
• Protect your skin from scratches and sores, such as from razors or nail files
• Avoid sharing utensils
• Avoid crowds and people who are ill
• Receive appropriate vaccinations