Lung transplant
- Introduction
- How to prepare for a lung transplant
- How a lung transplant is performed
- Risks of a lung transplant
- Recovering from a lung transplant
- 'My transplant was worth the risk'
- 'I could take a deep breath for the first time in years'
A lung transplant is an operation to remove and replace a diseased lung with a healthy human lung from a donor. A donor is usually a person who has died, but in some cases a section of lung can be taken from a living donor.
Lung transplants are not carried out frequently in the UK; mainly due to the lack of available donors. From April 2013 to April 2014 there were 179 lung transplants performed in England.
A lung transplant is used to treat:
- people with advanced lung disease who are failing to respond to other treatment
- a person whose life expectancy is thought to be less than two to three years without a transplant
Conditions that can be treated with a lung transplant include:
- chronic obstructive pulmonary disease (COPD) – a general term that refers to a number of diseases that damage the lungs, most commonly as a result of smoking
- cystic fibrosis – a genetic condition that causes the lungs and digestive system to become clogged up with a thick sticky mucus
- pulmonary hypertension – high blood pressure inside the vessels that carry blood from the heart to the lungs
- idiopathic pulmonary fibrosis – scarring of the lungs
Types of transplant
There are three main types of lung transplant:
- a single lung transplant – where a single damaged lung is removed from the recipient and replaced with a lung from the donor; this is often used to treat pulmonary fibrosis but is not suitable for people with cystic fibrosis as infection will spread from the remaining lung to the donated lung
- a double lung transplant – where both lungs are removed and replaced with two donated lungs; this is usually the treatment of choice for people with cystic fibrosis or COPD
- a heart-lung transplant – where the set of lungs and the heart is removed and replaced with donated heart and lungs; this is often recommended for people with severe pulmonary hypertension
Read more detailed information about a heart-lung transplant.
Will I be able to have a lung transplant?
The demand for lung transplants far outstrips the available supply. So a transplant will only be carried out if it is thought there is a relatively good chance of it being successful.
For example, a lung transplant would not be recommended for people with lung cancer as the cancer could reoccur in the donated lungs.
You will not be considered for a lung transplant if you currently smoke.
Living donors
Having a lung transplant from a living donor is sometimes possible.
Two living donors are usually required for one recipient. The lower lobe of the right lung is removed from one donor and the lower lobe of the left lung is removed from the other donor. Both lungs are then removed from the recipient and are replaced by the lung implants from the donors in a single operation.
Most people who receive lung transplants from living donors have cystic fibrosis. Most are close relatives of the recipients. The donors and the recipient need to be compatible in size and have matching blood groups.
Getting ready
Before being placed on the transplant list you will need a series of tests to make sure your other major organs (such as the heart, kidneys and liver) will function properly after the transplant.
It is also important to make lifestyle changes to get as healthy as possible when the time comes for the transplant to take place.
Read more about preparing for a lung transplant.
What happens during a lung transplant?
A lung transplant normally takes between four and 12 hours to complete, depending on the complexity of the operation.
A cut is made in your chest and the damaged lungs removed. Depending on your individual circumstances you may be connected to a bypass machine (heart and lung machine) to keep your blood circulating during the operation.
The donated lungs are then connected to the relevant airways and blood vessels and the cut is closed.
Read more about how a lung transplant is performed.
Risks
A lung transplant is a complex type of surgery and carries a high risk of complications.
A common complication is the immune system rejecting the donated lungs. Because of this, a type of medication called an immunosuppressive is given to dampen the effects of the immune system, reducing the risk of rejection. However, taking immunosuppressives carries its own risks as they make a person more vulnerable to infection.
Read more about risks associated with a lung transplant.
Recovery
A lung transplant is a major operation that may take at least three months to recover from.
It could be quite a while before you are able to return to work so you will need to make necessary arrangements with your employer.
Read more about recovering from a lung transplant.
Outlook
The outlook for lung transplants has improved in recent years and is expected to continue to improve in the future.
The British Transplantation Society estimates that around nine out of 10 people will survive for at least a year after a transplant and five out of 10 will survive for at least five years (there have been reports of people living for 20 years or more after a transplant).
Though complications can occur at any time, a serious complication is most likely to occur in the first year after the transplant.
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