Lung transplant process at Mayo Clinic

At Mayo Clinic, doctors from many specialties work as a team to develop the most appropriate plan of care for you. They take the time to listen to your questions and concerns and provide comprehensive care, including nutritional, social, financial and spiritual issues. They follow you before, during and, most importantly, after your lung transplant, to ensure the best possible results and quality of care.

Before your transplant

Doctors trained in lung transplantation will evaluate you to determine whether a lung transplant may be safe and beneficial for you. Your evaluation may last several days and may include:

  • Physical examination
  • Blood tests, including blood and tissue type analysis
  • Imaging tests, including chest CT scan
  • Cardiac catheterization
  • Lung function tests
  • Cardiovascular tests, including electrocardiogram, echocardiogram and cardiac catheterization
  • Consultations with doctors trained in lung diseases (pulmonologists), transplant surgeons, social workers and others

In addition, doctors will discuss with you what to expect after a lung transplant, including taking medications, lifestyle changes and other changes. Doctors will also explain to you the risks and benefits of transplant.

Pulmonologists, transplant surgeons and other specialists determine if you're eligible for a lung transplant. If you're approved for a lung transplant, you'll be placed on a waiting list for a donor lung. You may be on a waiting list from a few months to several years. You'll need to manage your current health condition and have regular follow-up appointments with your doctor.

While waiting for a donor lung, you'll need to stay in close communication with the transplant team and be prepared to get to the hospital quickly after you receive notice that a donor lung is available.

Once a potential donor lung is found, a transplant team member will instruct you to come to Mayo Clinic as soon as possible. You'll usually need to arrive within four to six hours. Mayo Clinic staff can help you coordinate any necessary air transportation to ensure rapid travel to Mayo Clinic when a donor organ becomes available.

Transplant surgery

Before your transplant, you'll have a physical examination, blood tests, urine tests, a chest X-ray and other tests. Doctors also will conduct a final assessment of the donor lung to ensure it's acceptable.

Lung transplant may include a single-lung transplant, a double-lung transplant, a heart-lung transplant or other procedures. In a double-lung transplant, surgeons remove one lung and then the second lung, and replace your lungs with donor lungs. In a heart-lung transplant, your lung and heart are replaced with a donor lung and heart. For a double-lung transplant or a heart-lung transplant, you're connected to a heart-lung bypass machine, which pumps blood through your heart and lungs during the surgery.

Before the surgery, you'll be given general anesthesia. Your surgeon will make a large incision in your chest. Your surgeon will cut the main airway and blood vessels attached to your lung, remove your lung, and place the donor lung in your chest. The main airway of the donor lung will be stitched to your airway and blood vessels.

After your transplant, you'll likely stay in the hospital one to three weeks to recover. During your hospital stay, your transplant team will monitor your recovery process. Your treatment team will provide you with instructions on post-transplant recovery, lifestyle changes and medications. Your team will show you how to check your lung function daily at home. You'll also participate in a pulmonary rehabilitation program to help improve your breathing.

After your transplant

After your transplant, you'll need to stay near Mayo Clinic for about three months so that your doctors can monitor your progress and recovery and monitor your lung for rejection.

  • Follow-up care. Your doctor will update your primary health care provider about your progress and give recommendations for your care at home. In addition, a certified transplant nurse coordinator will provide follow-up care for many months, answer your questions, and communicate with you and your primary health care provider.

    You'll have several follow-up appointments at Mayo Clinic for about three months. After you return home, you'll have follow-up appointments about once a month for three months and less frequently after that. In follow-up appointments, you'll have X-rays, blood tests, lung function tests, lung biopsies and other tests to check for signs of rejection. In a lung biopsy, doctors remove very small samples of your lung tissue to test for signs of rejection.

  • Medications. You'll need to take immunosuppressive medications daily for life to keep your body from rejecting your donor lung. Your transplant team will discuss your new medications in detail.
  • Returning to wellness. The transplant team considers your return to wellness after your transplant a priority. You'll be given specific guidelines to return to wellness through an exercise plan and a nutrition plan. You'll also participate in pulmonary rehabilitation. Staff may give you other lifestyle recommendations, such as wearing sunscreen and not using tobacco products. Your transplant team will work with you to help you make healthy lifestyle choices to achieve an optimal transplant outcome.

Read more about lung transplant.

April 22, 2015