Lung Transplant Surgery

After receiving the call that donor lungs have been located and you arrive at the hospital, you will be admitted and prepared for surgery. You will have a chest X-ray, EKG, and blood tests. At the same time, members of your transplant team will travel to the donor’s location so the surgeon can examine the donor lungs. It can take several hours to hear whether the donor lungs are acceptable. Sometimes, a transplant is cancelled because the surgeon discovered a problem with the lungs. We hope this will not happen to you, but if it does, you will not lose your place on the waitlist and will likely be called again in the near future.

Your surgeon will make an incision across your chest for a double (bilateral) lung transplant or along the side of your chest for a single transplant. You will be supported by a special breathing tube and other equipment as needed. For a bilateral transplant, the lungs will be attached one at a time. Your diseased lung will be removed, and the main airway to your lung and the blood vessels between your lung and heart will be connected to the donor lung. You will be under general anesthesia for the procedure, which will last about six to eight hours for a bilateral transplant. If you are having a multi-organ transplant or another procedure like a heart bypass at the same time, surgery will take longer. Your caregiver will be updated frequently on your progress.

After surgery, you will be taken to the Cardiothoracic Intensive Care Unit (CT-ICU).

• You will have a breathing tube in your mouth and throat and be on a respirator until you are able to breathe on your own. The tube may be removed a few hours or several days after surgery.
• You will have chest tubes for several days to drain fluid and air from the space around the new lungs and help them fully expand.
• Your transplant team will make sure that any pain you have is managed appropriately. Controlling pain lets you breathe deeply and helps prevent complications.
• About 12 hours after surgery, you will begin physical and occupational therapy with the help of specially trained physical therapists, respiratory therapists, and nurses. One goal is for you to be out of bed and walking as soon as possible. You will also work on swallowing, coughing, and breathing techniques.

When you are ready -- usually two to four days after surgery -- you will be moved to the cardiothoracic surgery step-down unit. There you will continue physical and occupational therapy and meet with your transplant coordinator. They will provide training and resources to make sure you and your caregiver understand how to take care of your new lungs. You will learn more about required exercise; medications; follow-up appointments and tests; diet; and protecting yourself from infection and rejection. The average stay in the hospital after lung transplant surgery is two to three weeks but can vary based on your condition.

Step 5: After Transplant