What is a lung transplant?
Lung transplant surgery is a lifesaving procedure to replace one or both diseased lungs with donor lungs. The team at the Penn Medicine lung transplant program is on-call at all times to step in when you match with donor lungs.
Who is a candidate for lung transplantation?
The evaluation and eligibility process for a lung transplant at Penn Medicine begins with a consultation appointment. We review your medical records, explain the steps in the lung transplant process, and answer your questions.
If we believe you may be a candidate for a transplant, you go on to a full medical and social evaluation and placement on the lung transplant waiting list.
General criteria for a lung transplant include:
- Age 75 or younger for a single-lung transplant or 70 or younger for a dual-lung transplant
- Advanced or end-stage lung disease
- Overall good health without cancer or other advanced disease
- Nonsmoking status
- Access to support for help and care while you recover
What to expect during lung transplant surgery
When donor lungs become available, we call and tell you to come to the hospital. At the same time, you transplant doctors go to the donor’s hospital to evaluate the lungs. Your loved ones are welcome to wait with you until you go to the operating room.
If we find the donor lungs are suitable for transplantation, we begin preparing you for surgery. If the lungs aren’t suitable for transplant, we’ll send you home. While this “dry run” is disappointing, it doesn’t change your position on the waiting list for donor lungs.
Lung transplant is an open-chest surgery. A single-lung transplant takes about three to four hours, and a double lung transplant (bilateral lung transplant) takes about six to eight hours. You’ll have general anesthesia so you stay asleep and comfortable during the procedure. During the surgery, your team will give your loved ones frequent updates.
You’ll be placed on a ventilator to help you breathe during your surgery. Your surgeon begins the procedure by making an incision across your chest. Your team closes off the airways and blood vessels to your diseased lung and removes it. Then they place the donor lung and connect your airways and blood vessels to it. Once blood and air are properly flowing in and out of your transplanted lung, your surgeon closes the incision.
What is lung transplant recovery like?
Your recovery care after lung transplant surgery begins as soon as you leave the operating room and we transfer you to an intensive care unit (ICU) room. Your family is welcome to be with you there.
A typical ICU stay after lung transplantation lasts three to five days. You’ll remain on the ventilator until you can breathe on your own. This can last for a few hours or a few days.
You receive medicine to control pain, prevent infections, and prevent organ rejection. As soon as you’re ready, you start physical therapy with your pulmonary rehabilitation team.
From the ICU, you move to a “step-down” hospital room, where you continue to recover and do physical therapy. During your hospital stay, we educate you and your family about the medications you’ll be taking. We’ll also discuss lifestyle changes you’ll make to support the health of your transplanted organ. Your hospital stay lasts about three weeks.
You’ll need to stay in Philadelphia for several months after discharge. You’ll come to the hospital a few times a week for tests and pulmonary rehabilitation therapy.
Risks after lung transplantation
Some of the risks of lung transplant surgery are similar to those of any major surgery, such as bleeding, blood clots, and infection. Risks specific to lung transplantation include:
- Rejection of the donor lung: Your immune system may recognize your donor lung as foreign and try to reject it. We give you powerful antirejection medications right after surgery, and you’ll continue to take immunosuppressant medication for life to prevent rejection. We watch you closely for signs of rejection, so we can start treatment to reverse the process as early as possible.
- Primary graft dysfunction: This serious lung injury happens within days or weeks after transplant. We monitor you closely for signs of organ failure so we can intervene quickly.
- Infection: Anti-rejection medications suppress your immune system to protect your transplanted lung. But a lowered immune system increases your risk of infection.
- Medication side effects: Immunosuppressant medication can cause kidney damage, increase your risk of developing certain cancers, and decrease your ability to fight infection.
Penn Medicine’s expertise with complex and high-risk lung transplants
As one of the top lung transplant centers in the U.S., we see a high volume of patients through the transplant journey and our results consistently exceed national averages. Our transplant physicians are recognized leaders in their field worldwide, holding leadership positions in the International Society for Heart and Lung Transplantation.
This experience gives us the skill and expertise to help even people with high-risk and complex situations that other transplant centers turn away, including lung-heart and lung-liver dual organ transplants.
At the Penn Transplant Institute, we understand that lung transplantation can be a long, emotional journey with many steps. Our family-focused care makes your loved ones welcome at every one of those steps, from our offices to your bedside. We’re honored to be part of your life.
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