Lung Transplant Surgery and Recovery

Arriving at the Hospital

When you arrive at the hospital for your transplant, you will have blood tests, a heart test called an electrocardiogram (EKG or ECG), 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. More 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.

A family supporting a lung transplant patient who sits in a hospital bed
Piper Beatty Welsh was surrounded by family prior to her second double-lung transplant. She describes the transplant 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. A breathing 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. Then they will make a cut, also called an incision. 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, another 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 be taken to the Intensive Care Unit (ICU), where you will stay for several days to be closely monitored.

Medications

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 exercise.

Your IV tubes will remain in place throughout your recovery. You will start receiving immunosuppressive or anti-rejection drugs through your IV as soon as your surgery is complete. When your body detects your new lungs, your immune system tries to fight what it thinks is a threat. These anti-rejection medications suppress your immune system’s response to allow your body to accept the new lungs. Your doctors will closely monitor the levels of these drugs in your blood to be sure that you're receiving exactly the right amount. Having either too much or too little of these drugs could be harmful to you.

Breathing and Eating

You will remain on the ventilator until you can breathe on your own. It may be removed after a few hours, or it may take a few days after surgery.

Once you are removed from the ventilator, they will closely monitor your swallowing and gradually transition you to eating solid foods. It may take days to months after transplant to start eating solid foods again. This is to help make sure food or drink do not go down the wrong tube and into your new lungs (aspiration).

Exercise

Nurses, physical therapists, and respiratory therapists will help you with your physical therapy and breathing exercises to prepare you for moving out of the ICU. When your medical team thinks 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.

Leaving the Hospital

You will stay in the hospital until your medical team is confident that you are strong enough and prepared to leave. Having a lung transplant is traumatic for your body, and you will be particularly vulnerable to 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.

Two adults with cystic fibrosis describe what their lives are like after transplant and address some of the challenges they faced during the recovery process.
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Lung Transplantation