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Lung Transplant Surgery: Preparation and Procedure

Lung transplant is a complex, but often life-saving, surgery for people with lung failure. The procedure involves removing one or both diseased lungs and replacing them with new healthy ones.

When You Get the Call That a Lung Is Available

Your UPMC transplant coordinator will call you when a donor lung or lungs become available.

Before coming to UPMC for your lung transplant:

  • Do not eat or drink anything.
  • Take an antimicrobial shower.
  • Pack your cell phone and charger.
  • Bring all your medications as well as medications for your caregiver, family, and support group.

The surgeon will evaluate the donor lung or lungs to make sure they are the right size and type and that the antibody panel is a match.

Lung Transplant Surgery: What to Expect When You Arrive

When you arrive at UPMC, we will admit you to a patient room where you will:

  • Have basic testing.
  • Have a history and physical done.
  • Sign consent forms for the lung transplant surgery.
  • See an anesthesiologist.

We will prep you for lung transplant surgery and give you general anesthesia.

The duration of lung transplant surgery depends on the complexity of your case.

  • For a single-lung transplant, surgery will take between 6 and 8 hours.
  • For a double-lung transplant, surgery will take 8 to 12+ hours.

What Happens During Lung Transplant Surgery?

During a lung transplant procedure, your surgeon will perform the following steps:

  • Make an incision in your chest.
  • Cut off the airways and blood vessels to your diseased lung.
  • Remove the diseased lung and replace it with the healthy donor lung.
  • Reattach the airways and blood vessels.
  • Close up the incision.

Your coordinator or surgeon will be able to provide more details about your specific surgery.

During the procedure — most often with a double-lung transplant — we may connect you to a heart-lung machine.

This machine supports your heart and lungs during surgery. It oxygenates your blood outside your body and pumps it back into your body.

Advanced techniques for complex lung transplants

UPMC's team of lung transplant experts performs many complex lung transplant operations. We're equipped to handle the risks of surgery and address any complications.

To expand the pool of suitable donor lungs, we use a process called ex vivo lung perfusion (EVLP), which keeps a pair of lungs alive outside the body so that a surgeon can evaluate them for transplant.

We use special techniques and surgical tools for transplanting lungs in people with small chests.

We also offer “bloodless” surgery for patients who meet strict health requirements. Bloodless medicine means we do not use banked blood products during the operation.

How Long Will I Be in the Hospital After Lung Transplant Surgery?

After lung transplant surgery, we will take you to the transplant intensive care unit (ICU) where you will stay for several days. Here, you will remain on a ventilator until you can breathe on your own. This may take a few hours to a few days.

We will give you pain medicine and anti-rejection drugs right away.

When your body detects your new lung or lungs, your immune system begins working to fight what it views as a threat. Anti-rejection drugs suppress your immune system's natural response to allow your body to accept the new lungs.

When you're stronger, you will move to a patient room within the transplant unit. You can expect to stay in the hospital for 3 to 4 weeks.

The lung transplant team will monitor your progress to make sure your body isn't rejecting the lungs and that you aren't developing an infection or other problems.

You'll begin rehabilitation, including physical therapy and breathing and speech exercises.

As you recover, your care team will have you up and moving to help prevent blood clots, and keep your smaller airways in your new lungs from collapsing.

You may be kept at NPO status (nothing by mouth) for days to months post transplant to ensure that your swallowing function is working correctly and also to prevent aspiration of food or drink into your new lungs.

Life After Lung Transplant

Before leaving the hospital, your lung transplant care team will review:

  • Your medication schedule.
  • Diet and exercise guidelines.
  • Follow-up visit schedule.

Be sure you both fully understand your at-home care plan before you leave the hospital.