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Surgery and recovery involves more than replacing your lungs. The process also includes making the physical and emotional adjustment to life with your new lungs.

Arriving at the Hospital

When you arrive at the hospital for your transplant, you will have blood tests, a test to examine your heart called an electrocardiogram (EKG), and a chest X-ray. 

Members of the surgical team will examine you and ask you questions. The anesthesiologist will start an intravenous (IV) line in your arm or your hand. Additional IV lines will be placed in your neck, wrist, collarbone, or groin areas to monitor your heart and blood pressure and to take blood samples. 

Piper Beatty Welsh was surrounded by family prior to her second double-lung transplant. She describes the transplantation process as, “life-saving, life-changing, and 100 percent life-affirming.”

What is Surgery Like?

You will be under general anesthesia for the surgery, so you will be unaware and won't feel any pain.

While you are under anesthesia, you will not be able to breathe on your own so a tube will be inserted through your mouth into your lungs. The tube will be attached to a machine called a ventilator, which will breathe for you during the surgery.

To prevent infection, the surgical team will thoroughly clean the areas of your skin they are preparing to cut. The incision, or the area where your skin is cut, will be a horizontal cut across your chest, under the breast area. Doctors will remove your unhealthy lungs (one at a time) and replace them with the donor lungs. The airways and blood vessels of the new lungs will be attached to your airways and blood vessels, one lung at a time.

Doctors will then close the incision with stitches or staples. A sterile bandage will be placed over the incision. One or more drainage tubes will be placed in your chest to let excess air, fluid and blood escape from the surgical site and to allow the lungs to expand completely.

Finally, an additional IV tube may be placed in your back to deliver pain medication to you. 

What to Expect Immediately After Surgery

After the surgery, you will either be taken to a recovery room and then to the Intensive Care Unit (ICU) or directly to the ICU. Once you are in the ICU, you will be attached to machines that will measure your vital signs. The nurses and doctors will monitor you closely to make sure you are recovering safely.

You should expect some pain after surgery. To make you more comfortable, you will receive pain medicine through an IV. Your transplant team will want you to be comfortable enough to cough, sleep, and participate in exercise.

You will not be able to breathe on your own immediately. Until you are strong enough to do so, you will have a tube in your throat so that a ventilator can help you breathe. It may be removed after a few hours or not until a number of days after surgery.

Once the doctors feel you are strong enough, the breathing and chest tubes will be removed. You may then be able to start drinking liquids. If you are able to tolerate liquids, you will slowly transition to eating solid foods.

Nurses, physical therapists, and respiratory therapists will help you with your physical therapy exercises and breathing exercises to prepare you for moving out of the ICU. When your doctors think you are ready, you will move from the ICU to a room in a nursing or transplant unit. You will gradually be able to increase your activity by getting out of bed, sitting up in a chair, and taking walks around the unit.

Your IV tubes will remain in place throughout your recovery. You will have begun receiving immunosuppressive drugs through these tubes as soon as your surgery was complete. Your doctors will closely monitor the levels of these drugs in your blood to be sure that you're receiving exactly the right amount, as having either too much or too little could be harmful to you. As you recover, you may be given other IV medicines to support your blood pressure, heart, kidneys, and liver. 

You will stay in the hospital until your doctors are confident that it is safe for you to leave. This is not always a smooth process. Having a lung transplant is traumatic for your body and you will be particularly vulnerable to the complications during this time. 

Before you are discharged, the transplant team will work with you to ensure that you are prepared to manage your recovery at home.