After Your Lung Transplant

Step Five: Taking Care of Your New Lungs

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A lung transplant can be a life-changing experience, but it requires a commitment to staying healthy. This means following a daily exercise routine, taking your medications according to schedule, attending all follow-up appointments, and abstaining from nicotine use. We will support you throughout the recovery process to help you achieve the best possible outcome.

For your convenience, video visits are available in many states.

Ready for an Evaluation?

If you are interested in making an appointment for an evaluation, please ask your pulmonologist to submit a referral.

Follow-Up Care After Lung Transplant Surgery

We ask that you stay in the Durham area for three to six months following your lung transplant so we can closely monitor your progress and you can participate in rehabilitation therapy.

Follow-Up Visits

You will have frequent visits with your lung transplant team for the first two or three months after you leave the hospital. At every follow-up visit, you will meet with members of your team and undergo testing to see how well you’re healing, monitor any medication side effects, and look for signs of rejection. Over time, these visits will occur less often, but you will still need to return to Duke for follow-up appointments -- in most cases twice a year. Your transplant coordinator will help you with your appointment schedule. Video visits are offered in many states.

Physical Therapy

You are required to participate in 23 or more physical therapy sessions (which takes about six weeks) through the Duke Cardiac and Pulmonary Rehabilitation Program. The pulmonary physical therapy staff will work with you to ensure you are exercising effectively and safely. Staying active can prevent some of the side effects of your medications and is one of the best things you can do to live a longer and healthier life. You are expected to exercise regularly for the rest of your life and will receive a detailed activity plan to use when you return home.

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Preventing Lung Transplant Rejection

Rejection happens when your body’s immune system detects that the cells in your new lungs are not exactly like those in the rest of your body, and it begins attacking them. The risk of rejection is highest during the first year after surgery but can occur at any time. To lower your risk of rejection, you will take immunosuppression drugs and other medications for the rest of your life.

Learn about Gary Klausner's journey from a life-threatening lung illness to the excellent health he enjoys today.

Treating Rejection

Rejection episodes are common for transplant recipients. In most cases, especially if detected early, they can be treated by increasing your dose of anti-rejection medication or with high-dose steroids. Signs of rejection may include fever, shortness of breath, decreased exercise tolerance, or lower pulmonary function. Many times, though, rejection occurs with no symptoms at all.

Regular Lung Biopsies

To check for the presence of rejection, you will have biopsies of your transplanted lungs (bronchoscopies) on a regular basis. During a lung biopsy, a flexible tube with a light and a camera at the end (called a bronchoscope) will be inserted through your nose or mouth and into your lungs. Your doctor will examine your lungs through the bronchoscope and collect samples of lung tissue. This material will be sent to a lab and tested for signs of rejection and infection. Most of the times, bronchoscopies are done at one month, three months, six months, nine months, twelve months, and then once a year unless there is a problem with your lungs. In this case, bronchoscopies may be done more frequently.

Our Locations

Lung transplant surgery is performed at Duke University Hospital. Pre- and post-transplant appointments take place at our pulmonology clinics in Durham.

Healthy Habits After Lung Transplant Surgery


In addition to lifelong immunosuppression drugs, you will need to take other types of medications. For instance, you may take steroids, drugs to help you avoid infections, vitamins, or medications to control acid reflux. Your transplant pharmacist, transplant coordinator, and others will help you manage and follow your medication routine.

Monitoring Vital Signs

To help your transplant team track your progress, you will be asked to record your lung function (with a micro spirometer that we will provide), your weight, and other vital signs and bring these records to your follow-up appointments. Changes in blood pressure, heart rate (pulse), temperature, and weight may indicate a need for medical attention.

Honoring Your Pre-Transplant Commitment

To increase the chances of a successful lung transplant, you will need to permanently abstain from using tobacco in any form. It is also important to follow the exercise routine recommended by your physical therapist, maintain a well-balanced diet, and take your medications as prescribed.

Best Hospital for Pulmonology and Lung Surgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our pulmonology and lung surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Avoiding Infection

Your immunosuppression medications help your body accept your new lungs, but they also increase the risk for infections, such as a cold, the flu, or other viral or fungal illnesses. This risk is greatest when you are on high doses of medication -- for instance, when you are being treated for an episode of rejection. You can lower your risk for infection by consistently washing your hands, avoiding crowds and sick people, and getting vaccines as recommend by your doctor.

Seeking Support

As a Duke lung transplant recipient, you are our patient for life. We can provide you and your caregivers the resources and support you need -- right after surgery and in the years to come. We know it is not always easy to follow new activity, diet, and medication requirements, but our transplant coordinators are always available to answer your questions and address your concerns. They can also connect you with other lung transplant recipients at Duke.

This page was medically reviewed on 12/08/2022 by