What you can expect

A surgeon and surgical team during surgery Lung transplant surgery

Mayo Clinic thoracic surgeons work with members of a surgical team to perform lung transplant surgery.

During your lung transplant

The procedure will be conducted with general anesthesia, so you will be unaware and won't feel any pain. You'll have a tube guided down your mouth and into your windpipe so you can breathe. A tube in your nose that goes down to your stomach will remove your stomach contents. A catheter will keep your bladder empty.

Your surgeon will make a cut in your chest to remove your diseased lung. The main airway to that lung and the blood vessels between that lung and your heart will then be connected to the donor lung. For some lung transplants, you may be connected to a heart-lung bypass machine, which circulates your blood during the procedure.

After your lung transplant

Immediately after the surgery, you'll spend several days in the hospital's intensive care unit (ICU). A mechanical ventilator will help you breathe for a few days, and tubes in your chest will drain fluids from around your lungs and heart.

A tube in a vein will deliver strong medications to control pain and to prevent rejection of your new lung. As your condition improves, you'll no longer need the mechanical ventilator, and you'll be moved out of the ICU. Recovery often involves a one- to three-week hospital stay. The amount of time you'll spend in the ICU and in the hospital can vary.

After you leave the hospital, you'll require about three months of frequent monitoring by the lung transplant team to prevent, detect and treat complications and to assess your lung function. During this time, you'll generally need to stay close to the transplant center. Afterward, the follow-up visits are usually less frequent, and it's easier to travel back and forth for follow-up visits.

Your follow-up visits may involve laboratory tests, chest X-rays, an electrocardiogram (ECG), lung function tests, a lung biopsy and checkups with a specialist.

In a lung biopsy, doctors remove very small lung tissue samples to test for signs of rejection and infection. This test may be conducted during a bronchoscopy, in which a doctor inserts a small, flexible tube through the mouth or nose into the lungs. A light and small camera attached to the bronchoscope allows the doctor to look inside the lungs' airways. The doctor may also use special tools to remove small samples of lung tissue to test in a lab.

Your transplant team will monitor you closely and help you manage immunosuppressant medications' side effects. Your transplant team may also monitor and treat infections. Your doctor might prescribe antibiotic, antiviral or antifungal medications to help prevent infections. Your transplant team may also instruct you about ways you can help prevent infections at home.

You'll also be monitored for any signs or symptoms of rejection, such as shortness of breath, fever, coughing or chest congestion. It's important to let your transplant team know if you notice any signs or symptoms of rejection.

You'll generally need to make several long-term adjustments after your lung transplant, including:

  • Taking immunosuppressants. You'll need to take immunosuppressant medications for life to suppress your immune system and prevent rejection of the donor lung or lungs.
  • Managing medications, therapies and a lifelong care plan. Your doctor may give you instructions to follow after your transplant. It's important to take all your medications as your doctor instructs, check your lung function as directed by your doctor, attend follow-up appointments and follow a lifelong care plan.

    It's a good idea to set up a daily routine for taking your medications so that you won't forget. Keep a list of all your medications with you at all times in case you need emergency medical attention, and tell all your doctors what you take each time you're prescribed a new medicine.

  • Living a healthy lifestyle. Living a healthy lifestyle is key to sustaining your new lung. Your doctor may advise you to not use tobacco products and to limit alcohol use. Following a nutritious diet also can help you stay healthy.

    Exercise is an extremely important part of rehabilitation after your lung transplant and will begin within days of your surgery. Your health care team will likely work with you to design an exercise program that's right for you. Your doctor may recommend pulmonary rehabilitation — a program of exercise and education that may help improve your breathing and daily functioning — after your transplant.

  • Emotional support. Your new medical therapies and the stress of having a lung transplant may make you feel overwhelmed. Many people who have had a lung transplant feel this way.

    Talk to your doctor if you're feeling stressed or overwhelmed. Transplant centers often have support groups and other resources to help you manage your condition.

Oct. 13, 2016
References
  1. What is a lung transplant? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/lungtxp. Accessed May 10, 2016.
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  3. AskMayoExpert. Lung transplantation. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
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  7. Hachem RR. Lung transplantation: General guidelines for recipient selection. http://www.uptodate.com/home. Accessed May 10, 2016.
  8. Partnering with your transplant team: The patient's guide to transplantation. U.S. Department of Health and Human Services. https://optn.transplant.hrsa.gov/learn/patient-education/. Accessed May 11, 2016.
  9. Valapour M, et al. OPTN/SRTR annual data report 2014: Lung. American Journal of Transplantation. 2016;16:141.
  10. Bhorade S, et al. Induction immunosuppression following lung transplantation. http://www.uptodate.com/home. Accessed May 10, 2016.
  11. Bhorade S, et al. Maintenance immunosuppression following lung transplantation. http://www.uptodate.com/home. Accessed May 10, 2016.
  12. What every patient needs to know. United Network for Organ Sharing. http://www.transplantliving.org/community/patient-resources/publications/. Accessed May 18, 2016.
  13. Diet and exercise. United Network for Organ Sharing: Transplant living. http://www.transplantliving.org/after-the-transplant/staying-healthy/diet-and-exercise/. Accessed May 13, 2016.
  14. Palmer SM, et al. Bacterial infections following lung transplantation. http://www.uptodate.com/home. Accessed July 13, 2016.
  15. What is pulmonary rehabilitation? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/pulreh. Accessed July 13, 2016.
  16. Cypel M, et al. Lung transplantation: Procedure and postoperative management. http://www.uptodate.com/home. Accessed May 10, 2016.
  17. What is bronchoscopy? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/bron. Accessed July 19, 2016.
  18. Erasmus DB (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 15, 2016.

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