Lung transplant - Recovering from a lung transplant

After surgery, you will remain in the intensive care unit for around one to seven days. You may have an epidural (a type of local anaesthetic) for pain relief and will be connected to a ventilator to help your breathing.

You will be carefully monitored so the transplant team can check your body is accepting the new organ. This monitoring will include regular lung X-rays and lung biopsies (where tissue samples are taken).

The transplant team can determine whether your body is rejecting the lung from the biopsy results. If it is, additional treatment will be given to reverse the process.

When your condition is stable, you will be moved to a high-dependency ward, where you will stay for one or two weeks.

Follow-up appointments

You will probably be discharged from hospital two to three weeks after surgery and asked to stay near the transplant centre for one month.

For the second month, you will need to visit weekly for four weeks. After that, for the rest of your life, you will have a blood test every six weeks and will be seen at the transplant centre every three months.

Getting back to normal

It normally takes at least three to six months to fully recover from transplant surgery. For the first six weeks after surgery, avoid pushing, pulling or lifting anything heavy. You will be encouraged to take part in a rehabilitation programme involving exercises to build up your strength.

You should be able to drive again four to six weeks after your transplant, once your chest wound has healed and you feel well enough.

Depending on the type of job you do, you will be able to return to work around three months after surgery.

Immunosuppressant therapy

You will need to take immunosuppressant medications, which weaken your immune system so your body does not try to reject the new organ.

There are usually two stages in immunosuppressant therapy:

• induction therapy – where you are given a combination of high dose immunosuppressants immediately after the transplant to weaken your immune system; you may also be given antibiotics and antivirals to prevent infection
• maintenance therapy – where you are given a combination of immunosuppressants at a lower dose to ‘maintain’ your weakened immune system

You will need to be treated with maintenance therapy for the rest of your life.

Most transplant centres use the following combination of immunosuppressants:

• tacrolimus 
• mycophenolate mofetil
• corticosteroids 

The downside of taking immunosuppressants is that they can cause a wide range of side effects, including:

• mood changes such as depression or anxiety
• insomnia
• diarrhoea 
• swollen gums
• bruising or bleeding more easily
• convulsions
• dizziness
• headache 
• acne 
• extra hair growth 
• weight gain

Your doctor will try to find the right dose that is high enough to 'dampen' the immune system, but low enough that you experience few side effects. This may take several months to achieve.

Even if your side effects become troublesome, never suddenly stop taking your medication because your lungs could be rejected.

Long-term use of immunosuppressants also increases your risk of developing other health conditions such as kidney disease – read more about the risks associated with long-term immunosuppressants use.

Avoiding infection

Having a weakened immune system is known as being immunocompromised. If you are immunocompromised, you will need to take extra precautions against infection. You should:

• practise good personal hygiene – take daily baths or showers and make sure that clothes, towels and bed linen are washed regularly
• avoid contact with people with infections that could seriously affect you – such as chickenpox or influenza (flu)
• wash your hands regularly with soap and hot water – particularly after going to the toilet and before preparing food and eating meals
• take extra care not to cut or graze your skin – if you do, clean the area thoroughly with warm water, dry it, then cover it with a sterile dressing
• keep up to date with regular immunisations – your transplant centre will supply you with all the relevant details

Be aware of any initial signs that you may have an infection. A minor infection could quickly turn into a major one.

Tell your GP or transplant centre immediately if you have symptoms of an infection. These include:

• fever (high temperature) of 38C (100.4F) or above
• headache
• aching muscles