Lung transplantation (2024)

A lung transplant is an operation in which a diseased lung is removed and replaced with a healthy human lung from a donor.

A donor is usually a deceased person, but in rare cases part of the lung can be taken from a living donor.

When a lung transplant is needed

A lung transplant is often recommended if:

a person has advanced lung disease that does not respond to other treatment methods
It is believed that the life expectancy of a person without a transplant is less than 2 to 3 years

Conditions that can be treated with a lung transplant include:

chronic obstructive pulmonary disease (COPD)– a general term for a number of conditions that damage the lungs, usually as a result of smoking
cystic fibrosis- an inherited condition that causes the lungs and digestive system to become clogged with thick, sticky mucus
pulmonary hypertension- high blood pressure in the blood vessels that carry blood from the heart to the lungs
idiopathic pulmonary fibrosis– scarring of the lungs

Types of transplantation

There are 3 main types of lung transplant:

a single lung transplant - in which a single damaged lung is removed from the recipient and replaced with a lung from the donor; this is often used to treat pulmonary fibrosis, but it is not suitable for people with cystic fibrosis because the infection will spread from the remaining lung to the donated lung
a double lung transplant – where both lungs are removed and replaced with two donated lungs; this is usually the main treatment option for people with cystic fibrosis or COPD
a heart-lung transplant– where the heart and both lungs are removed and replaced with a donated heart and lungs; this is often recommended for people with severe pulmonary hypertension

The demand for lung transplants far exceeds the available supply of donated lungs.

This means that a transplant is only performed if it is assumed that the chance of success is relatively high.

For example, a lung transplant would not be recommended for someone with diabeteslung cancerbecause the cancer could come back in the donated lungs.

Living donors

It is possible for someone to receive a lung transplant from living donors (usually 2 living donors are needed for 1 recipient).

But lung transplants from living donors are currently rare in Britain.

In this type of lung transplant, the lower lobe of the right lung is removed from one donor and the lower lobe of the left lung is removed from the other donor.

In one operation, both of the recipient's lungs are removed and replaced with the donor's lung implants.

Most people who receive lung transplants from living donors have cystic fibrosis and their donors are close relatives.

The recipient and donors must have matchingblood groups.

Preparation

Before you are placed on the transplant list, you will need to undergo a number of tests to ensure that your other major organs, such as your heart, kidneys, and liver, will function properly after the transplant.

You may also need to make lifestyle changes, such as quitting smokinglose weightif you are overweight, so that you are as healthy as possible when the time comes for the transplant.

The lung transplant procedure

A lung transplant usually takes between 6 and 8 hours, depending on the complexity of the surgery.

An incision is made in your chest and the damaged lungs are removed.

Depending on your individual circ*mstances, you may be connected to a heart and lung bypass machine during surgery to keep your blood circulating.

The donated lungs are then connected to the appropriate airways and blood vessels and the chest is closed.

Read more about how a lung transplant is performed

A lung transplant is a major operation, the recovery from which can take several months.

It may take some time before you can return to work. You must make the necessary agreements with your employer for this.

Read more about recovering from a lung transplant

Risks

A lung transplant is a complex form of surgery that carries a high risk of complications.

A common complication is that the immune system rejects the donated lungs.

Therefore, a drug known as an immunosuppressant is given to dampen the effects of the immune system, reducing the risk of rejection.

But taking immunosuppressants comes with its own risks because they increase the chance of infection.

Read more about the risks associated with a lung transplant

Outlook

The outlook for people who have undergone a lung transplant has improved in recent years and is expected to continue to improve.

In 2022, the NHS Blood and Transplant Service reported that on average:

83 in 100 people still live 1 year after a lung transplant
55 out of 100 people still live 5 years after a lung transplant

NHS Organ Donor Register

All adults in England are considered organ donors when they die, unless they have opted out or are in an excluded group.