Lung Transplant

Lung Transplant

Among the Nation’s Best Lung Transplant Centers

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You may be considering lung transplant surgery if end-stage lung disease has severely damaged your lungs. The lung transplant process is a difficult, life-changing experience. However, the entire Duke lung transplant team -- including pre- and post-transplant coordinators, doctors and surgeons, nutritionists, rehabilitation specialists, psychologists, social workers, and counselors -- is here to support you through every step of your journey. If you are a candidate for lung transplant surgery, we help you get your life back, unencumbered by lung disease.

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Lung Transplant Process

Lung Transplant Evaluation

Our comprehensive evaluation considers your overall health and support system. You will undergo extensive medical testing of your heart, lungs, and gastrointestinal system. You will also meet with a psychologist, nutritionist, pharmacist, social worker, and financial coordinator. We use this lengthy and detailed evaluation to assess whether you will benefit from lung transplantation. Read more in our Before Your Lung Transplant guide. 

Preparing for a Lung Transplant

If you become a lung transplant candidate, you will spend several weeks participating in supervised exercise and transplant education classes led by our lung transplant team. If you live outside our area, we help you relocate to Durham so you can prepare for the surgery. You and your caregivers will learn about the lung transplant process, the medications you will take, and the recovery process. Read more in our After Your Lung Transplant guide.

Pre-Transplant Physical Therapy

Daily pre-transplant physical therapy is an integral part of our lung transplant program. It is led by respiratory and physical therapists who specialize in preparing people for lung transplant surgery and recovery. They will monitor your oxygen needs, teach you breathing and stretching techniques to help you after transplant, and lead you in exercise to build up your body in preparation for surgery. The stronger you are before the transplant, the better your chance of getting through the surgery without significant complications.

Caregiver Support

Early on, you will need to focus all your efforts on rebuilding your strength and adjusting to your new lungs. Your transplant caregivers will organize your medications, make sure you are taking them correctly, and get you to and from all of your medical and physical therapy appointments. Your caregivers are vital partners in your transplant and recovery. We include them in the pre-transplant educational program so that, together, you and your caregivers will be prepared for the transplant process and your new life after transplant.

Lung Transplant Waitlist

When the time is right, your name will be added to the waitlist for a lung transplant. This is the national database maintained and administered by the United Network for Organ Sharing (UNOS) to allocate donor lungs in the United States. Being “on the list” means our surgeons are looking for suitable lungs for you. Lungs are allocated based on blood type, distance from donor hospital, and lung allocation score. Our surgeons then look at the details of the donor to decide if the lungs are right for you. Unfortunately, not everyone listed for a transplant will receive one, since there are not enough organs available for transplant. However, our rates of death on the waitlist are some of the lowest in the country.

Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.

Lung Transplant Recovery

Staying Local After Transplant

We ask that you stay in the Durham area for three to six months following your lung transplant, depending on your clinical status, so we can closely monitor your progress and ensure a successful outcome. You will return to physical therapy after the transplant to recover from the surgery, build back your strength, and help you become independent again. Although organ rejection may occur following transplants, our personalized approach to anti-rejection therapy makes rejection uncommon. Read more in our After Your Lung Transplant guide.

Available Resources

A lung transplant coordinator will facilitate your ongoing care needs. For urgent needs, a coordinator is on call 24 hours a day, 365 days a year. A lung transplant doctor is also on call at all times if your local doctor needs to reach us. We offer a formal caregiver support group, coping skills training program, and nonpharmacologic pain management strategy class at our rehab center. Many patients and caregivers find the community of others who are preparing for or recovering from their lung transplants at Duke to be invaluable through this challenging process.

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Selecting a Lung Transplant Program

These questions and our answers can help you evaluate whether our lung transplant center meets your needs.

How Many Lung Transplants Has Your Center Performed?
We are a high-volume lung transplant program and the largest lung transplant program in the Southeast. More than 2,000 lung transplants have been performed at Duke since 1992. Our lung transplant surgeons performed 107 lung transplants in 2018.

What Types of Patients Receive Lung Transplants at Your Center?
We routinely perform lung transplantation in patients with end-stage lung disease related to:

As one of the first U.S. centers to perform lung transplants in people ages 65 and older, we have extensive experience with this population and the challenges involved. In fact, our program has no fixed upper age limit. We also have experience with people who have complex illnesses, including multi-drug resistant infections, immunologic deficiencies, coronary artery disease, and valvular heart disease.

We are also experienced in performing lung retransplants in people who develop chronic rejection after lung transplant.

What Kinds of Lung Transplants Do You Perform?
We perform both single- and double-lung transplants. Whether you receive a single- or double-lung transplant depends on many factors, including your underlying disease, prior chest surgeries, and anticipated difficulty of finding a suitable donor for you. While the majority of patients receive double-lung transplants, our transplant surgeons develop a customized surgical plan for each patient.

Do You Perform Multi-Organ Transplants?
For some patients, a lung transplant alone may not be enough to restore their health. Our transplant surgeons are experienced in multi-organ transplants, including heart-lung, lung-liver, lung-kidney transplants and triple transplants of the heart, lungs, and liver.

What Is the Typical Wait Time for a Lung Transplant?
Median wait time on our lung transplant list is about 15 days, compared to 94 days nationwide. Our shorter lung transplant wait times are due, in part, to our aggressive and innovative organ-recovery efforts. This approach enables us to procure and successfully transplant more viable organs in more patients who need them. It also reduces the chance of death while waiting for lung transplant surgery.

Median Wait Time for Lung Transplant (in Days)

Source: Scientific Registry for Transplant Recipients Program-Specific Report, July 2019

What Steps Do You Take to Ensure the Best Possible Outcomes?  
Lung transplantation is a high-risk procedure, so every effort goes into maximizing your chances of doing well. 

  • We Focus on the Role of Mental Health in Lung Transplant Outcomes
    Our transplant psychologists work closely with you to make sure you are prepared for the emotional and psychological stress of lung transplantation. 
  • We Employ Organ Rejection Prevention and Treatment Strategies
    Our efforts positively impact our lung transplant survival rates and increase your life expectancy after lung transplant.

Lung Transplant Research

Dedicated to Improving Outcomes
We are dedicated to improving the outcomes of lung transplant recipients and know that research drives progress. Our researchers have made significant contributions to the field of lung transplantation, notably our understanding of risk factors for chronic rejection, the impact of cytomegalovirus (CMV) infection and gastroesophageal reflux on lung transplant outcomes, and the different forms of chronic lung allograft dysfunction (when a transplanted lung doesn't work well).

Understanding of Infection, Rejection
As recipients of a five-year, $13M Clinical Trials in Organ Transplantation (CTOT) grant, we collaborate with four other leading lung transplant centers to advance the understanding of infection and chronic rejection, which affect more than half of lung transplant recipients.

Expanding Donor Options
We have also been a leader in expanding the donor pool through the use of ex-vivo lung perfusion, a method of keeping donor lungs in good condition for transplantation.

Duke University Hospital is nationally ranked in 10 adult specialties
Best Hospital for Pulmonology and Lung Surgery in NC
When it comes to your care, you want the very best. Duke University Hospital's nationally ranked pulmonology and lung surgery program was named best in North Carolina by U.S. News & World Report for 2019–2020.
Reviewed: 04/04/2019