A lung transplant is a type of surgery that replaces one or both of your damaged or diseased lungs with a donor’s healthy lungs. It’s a necessary procedure if you have a lung condition or injury that doesn’t respond to other treatments. Risks include rejection and infection. Many people return to a good quality of life within three to six months.
A lung transplant is a type of surgery that replaces your diseased or damaged lung with a donated lung. Most donated lungs come from a deceased person.
To receive a lung transplant, you must have a serious lung condition that doesn’t respond to medications and other treatments.
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There are three main types of lung transplant:
In general, you’re a good candidate for a lung transplant if:
Your healthcare provider may recommend a lung transplant if you have a lung condition or injury that hasn’t responded to medications or therapies.
Lung transplantation may treat many different conditions, including:
In 2019, healthcare providers performed about 2,500 lung transplants. However, more people need a lung transplant than are transplantable lungs available. Several hundred people die each year while waiting for a lung transplant, and lung transplant providers are working very hard to increase the number of lungs that can be transplanted to address this need.
Before a lung transplant, you must go through a thorough pre-transplant screening. A pre-transplant screening is the first step in determining if a lung transplant is the best treatment for you. A special healthcare provider known as a transplant coordinator will gather medical information about you and your condition. This information includes:
Your healthcare provider will conduct a Pap smear and a mammogram for women and people assigned female at birth (AFAB). Your healthcare provider will conduct a prostate exam for men and people assigned male at birth (AMAB).
After your pre-transplant screening, your transplant coordinator and other members of your lung transplant team will meet. They’ll evaluate your tests and discuss whether a lung transplant is the best treatment.
Once your healthcare providers have finished their evaluations and determined you’re a good candidate for a lung transplant, they’ll put you on a national lung transplant waiting list.
You must match the following requirements with your donor:
Because there are so many people on the lung transplant waiting list, you may be on a lung transplant list for months or even years. You may die before a suitable donor is available. But if you don’t have any issues that make it difficult to find a matching donor, such as antibodies (proteins) in your blood that react against many donors, and you’re ill, you’ll likely receive a lung transplant within a few months of being placed on the waiting list.
The healthcare providers on your lung transplant team generally include:
Once you’re on the lung transplant list, your healthcare providers will work with you to create a healthcare plan. Your healthcare plan will include:
Your healthcare provider will insert an intravenous (IV) line into a vein in your arm or hand. The IV delivers anesthesia into your body so you aren’t awake and won’t feel any pain during the lung transplant. They’ll monitor your heart and blood pressure with an electrocardiogram (EKG).
Your positioning on the operating table may depend on what type of lung transplant you need. While single lung transplants can be done with you lying on your back, you may lie on your side. You’ll lie on your back for a double lung transplant or a heart-lung transplant.
Once you’re asleep, your healthcare providers will connect you to a mechanical ventilator. A mechanical ventilator breathes for you. They’ll also insert a urinary catheter into your bladder. The catheter will collect any urine (pee) that your body produces during the procedure.
Your procedure may require a mini heart-lung machine called ECMO (extracorporeal membrane oxygenation). An ECMO machine allows your transplant surgeon to bypass blood flow to your heart and lungs. It pumps blood through your body. It also removes carbon dioxide and replaces it with oxygen, which helps keep your tissues healthy.
Your healthcare providers may need to prepare the area by shaving your chest. They’ll sanitize your skin with an antiseptic to kill any bacteria.
For a single lung transplant, your healthcare provider will use a sharp, sterile knife (scalpel) to make a cut (incision) on the side of your chest that contains the damaged lung that’ll be replaced. Some single lung transplants are done through an incision through your breast bone, as with heart surgery.
For a double lung transplant, your healthcare provider will use a scalpel to make a horizontal incision across your entire chest, underneath your breast tissue. An incision, as with heart surgery (sternotomy), can also be used for a double lung transplant.
Your healthcare providers will remove your diseased or damaged lung and replace it with your donor’s lung. They’ll connect your blood vessels and airways with small surgical needles and thread. Blood vessels allow your transplanted lung to receive blood (vascularization). Vascularization keeps your tissues alive.
Once your healthcare providers have confirmed that blood flows to your transplanted lung and air passes through your airways, they’ll place small silicone tubes in your affected areas to drain blood, fluid and air out of your chest. These drainage tubes also help your new lungs expand entirely.
They’ll also disconnect you from any machines that were used to facilitate the surgery. They won’t remove the mechanical ventilator or the catheter.
Finally, they’ll stitch (suture) your incision closed and cover your affected areas with bandages.
A lung transplant is a delicate procedure that requires a lot of time. Its length depends on whether you need a single lung transplant or a double lung transplant.
A single lung transplant may take four to eight hours.
A double lung transplant may take six to 12 hours.
After the lung transplant procedure is complete, your anesthesiologist will stop putting anesthesia into your body. You’ll move to an intensive care unit (ICU), where your healthcare providers wait for you to wake up and monitor your overall health. While in the ICU, the mechanical ventilator will continue to help you breathe.
Once your providers believe it’s safe, they’ll take you off the mechanical ventilator, remove the catheter and move you to a post-transplant unit. They’ll monitor how you and your body respond to immunosuppressive drugs and adjust your dosages as necessary.
As your body heals in the post-transplant unit, you’ll start working with physical therapists and respiratory therapists to build up strength in your body and lungs.
After you’ve made enough progress and your healthcare providers believe it’s safe, they’ll discharge you (let you go home). You’ll be in the hospital between 12 and 14 days after surgery or perhaps longer, if necessary.
A lung transplant positively affects your overall quality of life. The primary advantages of a lung transplant include:
A lung transplant has many risks, including:
Several signs indicate your body is rejecting your transplanted lung. If you experience any of the following symptoms, contact your healthcare provider immediately:
With immediate diagnosis and treatment, most people recover after their body rejects their lung transplant.
Your healthcare provider will conduct tests to diagnose lung transplant rejection, including blood work and a bronchoscopy.
If your body rejects your lung transplant, your healthcare provider will administer high-dose corticosteroids through an IV, followed by corticosteroid pills.
As mentioned, chronic rejection is much more difficult to treat and treatment is unpredictable. Some people respond and stabilize, while others deteriorate and die, or qualify for another transplant.
For at least three months after you leave the hospital, you must return frequently for regular treatment, therapy and monitoring. Your appointments will include physical therapy, blood tests and imaging tests.
Your incision should heal about two weeks after your lung transplant.
Although you’ll be walking in the hospital and when you leave the hospital, progression to other forms of light exercises will take about six to eight weeks after the procedure. You’ll be guided by your healthcare providers in this regard. Though exercise is necessary as you recover, listening to your body is also important. Stop and rest if you feel discomfort or pain. Avoid contact sports or activities that may affect your chest, including football, baseball, golf and bowling for about three months.
You should be able to drive about six to eight weeks after the procedure.
After three to six months, your risk of lung transplant acute rejection decreases and your lung function should stabilize.
Most people return to work or school after four to six months.
It’s important to remember that your body is unique. Your recovery times and benchmarks after your lung transplant may vary. It’s important to follow your healthcare provider’s instructions.
After a lung transplant, schedule regular follow-up appointments with your healthcare providers. You may require multiple appointments every week for testing and therapy for six months after your procedure.
Call your healthcare provider immediately if you aren’t feeling well or if you notice any discomfort or changes to your transplant site.
Talk to your healthcare provider before you start taking any new medicines. New medications may include prescribed and OTC medications and herbal supplements.
A note from Cleveland Clinic
A lung transplant is a serious surgery with the potential to improve your quality of life. You must go through a thorough pre-screening before you’re placed on the lung transplant waiting list. Once you’re on the list, you must be diligent to maintain physical activity and fitness, maintain nutrition and adhere to the agreed-upon medical plan. The recovery process after a lung transplant is long. Your body is more likely to reject your lung within the first year after the procedure.
Getting a lung transplant is a major decision. Your healthcare provider is available to answer your questions and make sure you’re comfortable with your choices.
Last reviewed by a Cleveland Clinic medical professional on 05/18/2022.
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