Lung Transplant

There are many steps you’ll need to go through before you get your new lung. For starters, we’ll want to make sure you’re eligible for one. So we’ll do some pre-screening. We’ll go over your health history and ask what medications you’re taking — especially blood thinners, which could affect your surgery outcome. And we’ll also do some tests.

Blood and tissue testing

We’ll run blood and tissue-typing tests so we can find out more about your body’s tissues and how compatible they’ll be with your donor’s. We want to be sure we find your perfect match.

Imaging tests

Your providers will also have you do some imaging tests so they can get a better look at your lungs. These could include CT scans (computed tomography scans) and chest X-rays.

Lung tests

We’ll do a few tests on your lungs to see how they work. These tests include:

• Spirometry: Measures how much air goes in and out of your lungs when you breathe.
• Lung volumes (body plethysmography): Shows how much air is in your lungs when you inhale and exhale.
• Gas diffusion study: Measures how well your lungs send oxygen to — and remove carbon dioxide from — your blood.

Heart tests

Your providers will also do these tests to see how well your heart works:

• Electrocardiogram (EKG).
• Echocardiogram (Echo).
• Cardiac catheterization.

Other tests

To make sure you’re healthy enough for a lung transplant, your providers will also do a colonoscopy to check for colon cancer. If you’re a woman or assigned female at birth (AFAB) and are the appropriate age, they’ll do a Pap smear and a mammogram. If you’re a man or assigned male at birth (AMAB), you’ll have a prostate exam.

Meet Our Lung Transplant Team

At Cleveland Clinic, you’ll have a care team of experienced providers from many different areas. They’re specially trained to support you throughout the entire transplant process. These experts are committed to meeting your unique needs and providing compassionate, comprehensive care. Your lung transplant team will include:

• Transplant coordinators.
• Transplant pulmonologists.
• Transplant surgeons.
• Anesthesiologists.
• Respiratory therapists.
• Physical therapists.
• Pulmonary rehabilitation.
• Social workers.
• Transplant pharmacists.
• Transplant psychiatrists.
• Transplant nutritionists.
• Transplant infectious disease.
• Transplant hepatologists (liver doctors).
• Transplant financial counselors.

Once we know that you’re a good candidate for a lung transplant, we’ll start the process of making this happen. This isn’t always a fast process, and we know it can be stressful. But we’ll support you every step of the way.

Waiting for a donor lung

After you’ve completed testing and been approved by our transplant program to receive a new lung, the next step is to get on a national lung transplant waiting list. Your providers will do this for you. To match with a donor, you need to have either the same blood type or a compatible blood type. Your lung allocation score (which represents your risk of dying while waiting for a transplant and your chance of survival after a transplant) will also be considered.

Often, if you don’t have issues that make it hard to find a donor, you might be able to get your transplant within a few weeks to months of joining the waiting list.

Getting ready for lung transplant surgery

Once you’re on the transplant waiting list, you’ll have to follow a specific plan to prepare for surgery so you can have the best results. You’ll want to stay as healthy as possible, and if needed, make lifestyle changes, like:

• Not drinking alcohol.
• Maintaining a weight that that’s healthy for you.
• Following a prescribed exercise program.

As you prepare, we’ll see you for regular appointments to make sure you’re staying healthy enough for surgery.

When a donor lung becomes available, things will move fast. It’s a good idea to have a plan in place before this happens. Who will drive you that day? What are you taking with you to the hospital? You might even want to have a bag packed with the things you want to take — comfortable clothes, reading material, chargers for your electronics, toiletries and whatever else will make you feel more at ease during your stay. And don’t worry, we’ll remind you about what to bring when it’s time to come to the hospital for surgery.

We also have several interactive video classes that’ll help you prepare for surgery. These videos will go over things like:

• What to do when you’re on the transplant waiting list.
• Preparing for the day of your transplant surgery.
• Types of lung donors.
• The medicine you’ll take after transplant surgery.

You’ll also be able to interact virtually (online) with a transplant recipient and their care partner to ask questions about having a lung transplant.

Once you get a donor match from the waiting list, it’s time to act fast and go to surgery. Lung transplants usually take between four and eight hours for a single lung and six to eight hours for both lungs.

What to expect during surgery

Before your lung transplant, you’ll get anesthesia so you aren’t awake and won’t feel any pain during surgery.

Here’s what happens next:

• We’ll monitor your heart rate and blood pressure throughout the surgery. You’ll also be connected to a mechanical ventilator (breathing machine) that’ll breathe for you during surgery.
• You might be hooked up to a mini heart-lung machine, which will let your surgery team bypass blood flow through it that normally goes to your heart and lungs. The machine will pump blood through your body and also help provide oxygen to your organs and tissues.
• After making an incision (cut), we’ll remove your diseased or damaged lung and replace it with your donor’s lung. Next, we’ll connect your blood vessels and airways to the new lung so it can start receiving blood.
• Once we’re sure that blood’s flowing to your transplanted lung and air is passing through your airways, we’ll finish up surgery and move you to the transplant intensive care unit (ICU).

What to expect right after surgery

While you’re in the ICU, you’ll still be hooked up to a ventilator and your provider will keep an eye on you as you wake up.

When we feel it’s safe (usually within a few days), we’ll take you off the ventilator and move to a specialized step-down floor of the hospital, where you’ll:

• Get anti-rejection medications to help your body accept your new lung.
• Learn about these medications and how to take care of your new lung.
• Talk with your providers about lifestyle changes and nutrition, if needed.
• Continue to get physical therapy.

What to expect when you leave the hospital

While everyone’s lung transplant surgery is different, you’ll typically be discharged from the hospital between 14 and 21 days after surgery, but it could be longer. For a while, you’ll need to stay within one hour of Cleveland Clinic after you leave the hospital.

Once you’re discharged, you’ll continue to recover. In six to eight weeks, you should be able to do light exercise and start driving again. And, depending on your stamina, how you’re tolerating your medications and overall health, you can usually go back to school or work after four to six months.

It’s important to remember that everyone heals differently, and this timeline is just a guide. You might recover faster or slower than these estimates.

Lung Transplants With Other Health Conditions at Cleveland Clinic

Have you been told by another provider that you aren’t eligible for a lung transplant because:

• You also have a severe health condition, like coronary artery disease, heart valve disease or scleroderma?
• You have heart or liver failure and need a multi-organ transplant?

Some providers won’t do a lung transplant if you have a high-risk condition or need more than one transplant because there could be complications that could affect how successful the lung transplant is.

At Cleveland Clinic, we regularly treat people who’ve been told a lung transplant isn’t an option. Our providers are experts at treating high-risk conditions and doing multi-organ transplants. And we can often transplant both organs in a single surgery.

Taking the Next Step

End-stage lung disease is probably not something you ever thought you’d have to face. And the process of getting a lung transplant can seem overwhelming and make your head spin. There are certainly a lot of steps — from finding out if you’re even eligible for a transplant, to getting on the waiting list, to having the surgery and then recovering. It isn’t an easy or quick process, but it can be a life-saving one. Our highly skilled and caring specialists have helped many people navigate the lung transplant process and turn their lives around. We’d like to help you, too.