Lung transplant

A lung transplant is an operation to remove and replace a diseased lung with a healthy human lung from a donor.

A donor is usually a person who's died, but in rare cases a section of lung can be taken from a living donor.

Lung transplants aren't carried out frequently in the UK. This is mainly because of the lack of available donors. In England, during 2013-14, 198 lung transplants were carried out.

When a lung transplant is needed

A lung transplant will often be recommended if:

• a person has advanced lung disease that isn't responding to other methods of treatment
• a person's life expectancy is thought to be less than two to three years without a transplant

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 up with a 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 transplant

There are three main types of lung transplant:

• a single lung transplant – where 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 isn't suitable for people with cystic fibrosis because 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 is far greater than the available supply of donated lungs. Therefore, a transplant will only be carried out if it's thought there's a relatively good chance of it being successful.

For example, a lung transplant wouldn't be recommended for someone with lung cancer because the cancer could reoccur in the donated lungs.

You also won't be considered for a lung transplant if you smoke.

Living donors

It's possible for a person to receive a lung transplant from living donors (two living donors are usually required for one recipient). However, lung transplants from living donors are currently rare in the UK.

During 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. Both lungs are removed from the recipient and replaced with the lung implants from the donors in a single operation.

Most people who receive lung transplants from living donors have cystic fibrosis and are close relatives of the donors. The recipient and donors need to be compatible in size and have matching blood groups.

Preparation

Before being placed on the transplant list you'll need to have some tests to make sure 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 giving up smoking and losing weight (if you're overweight), so that you're as healthy as possible when it's time for the transplant to take place.

Read more about preparing for a lung transplant.

The lung transplant procedure

A lung transplant usually takes between four and 12 hours to complete, depending on the complexity of the operation.

A cut is made in your chest and the damaged lungs removed. Depending on your individual circumstances, you may be connected to a heart and lung bypass machine to keep your blood circulating during the operation.

The donated lungs will then be connected to the relevant airways and blood vessels and the chest will be closed.

Read more about how a lung transplant is performed.

A lung transplant is a major operation that may take at least three months to recover from. It could be quite a while before you're able to return to work so you'll need to make necessary arrangements with your employer.

Read more about recovering from a lung transplant.

Risks

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

A common complication is the immune system rejecting the donated lungs. As a result of this, a medication known as an immunosuppressive is given to dampen the effects of the immune system, reducing the risk of rejection. However, taking immunosuppressives carries its own risks as they increase the chances of infection.

Read more about risks associated with a lung transplant.

Outlook

The outlook for people who've had a lung transplant has improved in recent years and it's expected to continue improving.

The British Transplantation Society estimates that around nine out of 10 people survive a lung transplant, with most of these surviving for at least a year after having the operation.

About five out of 10 people will survive for at least five years after having a lung transplant, with many people living for at least 10 years. There have also been reports of some people living for 20 years or more after a lung transplant.

Although complications can occur at any time, a serious complication is most likely to occur in the first year after the transplant.

The NHS Organ Donor Register

In the UK, consent (permission) is required before organs can be donated. A person can give their consent by joining the NHS Organ Donor Register or by discussing their wishes with loved ones.

Joining the NHS Organ Donor Register is a failsafe way of ensuring your wishes are made clear. It means there's a permanent record of your wishes that doctors can check in the event of your death.

Joining the NHS Organ Donor Register is quick, simple, and you can remove yourself from it at any time.

Read more about organ donation.