Lung Transplantation Process

Montefiore Einstein offers you world-renowned care during every stage of your lung transplantation—before, during and after surgery.

You may be referred for transplantation due to your specific type of lung disease and how far it has progressed. Among the most common symptoms indicating a need for transplantation are shortness of breath, especially during exertion; a need for supplemental oxygen; low energy; tightness in your chest; chronic coughing or wheezing; and swelling in your lower legs, ankles and feet.

Transplantation is not the right choice for every person with lung disease. To be eligible for transplantation, patients must have no active infections or cancer and must be healthy enough to undergo the surgery. You are eligible for evaluation for lung transplantation once you have been nicotine-free (including smoking and chewing tobacco) for at least six months. If you resume smoking or nicotine use after transplantation, your likelihood of getting a life-threatening illness is significantly increased due to the side effects of antirejection medications.

During an evaluation for transplantation, Montefiore Einstein’s multidisciplinary transplantation team will review your medical history, conduct a physical examination, order additional tests and assess your emotional preparedness for transplantation surgery and recovery.

Once you have been determined to be a good candidate for a lung transplantation, we will immediately place you on the national waiting list. Getting a lung transplantation may take weeks, months or even years, depending on the length of time before donor lungs are available. There are currently more people in need of new lungs than there are donor lungs available.

The United Network for Organ Sharing (UNOS) matches a donor lung with you by considering these factors: blood type, distance between donor organ and patient (traditionally, lungs should be transplanted within four to eight hours of availability), physical size of donor lung and recipient, severity of the condition and likelihood that the transplant will be successful. You may reach out to UNOS with any questions by calling 1-888-894-6361 or going online at UNOS.org at any time.

Donors are thoroughly screened, but there is a small possibility of contracting a disease from the donor. Antirejection medication can increase your risk of cancer. Your physician will discuss any additional risks with you in detail. During this time, we also offer support services, including dedicated social workers who can assist you and your family and address any concerns you may have.

Please consult this short checklist of dos and don’ts immediately before your transplant surgery.

For a single lung transplantation, surgery typically takes six to eight hours; a double lung transplantation takes eight to twelve hours. You will be placed under general anesthesia and may be placed on a heart-lung machine, which oxygenates blood by pumping it through an artificial lung. Your diseased lung is removed and replaced with the healthy lung. The surgeon reattaches the blood vessels and airways and closes the incision.

After lung transplantation surgery, you will spend four to six days in the transplant intensive care unit (ICU). You will be placed on a ventilator until you can breathe on your own, which can take from three hours to three days. During lung transplantation recovery, antirejection drugs are administered to suppress your immune system and allow your body to accept the new lung.

Once stable, you will move to our dedicated transplant floor for three to four weeks and be monitored continuously by our multidisciplinary care team. You will also begin rehabilitation and physical therapy, including breathing and speech exercises. Before returning home, you will receive comprehensive diet and exercise guidelines, medication instructions and a schedule for your upcoming appointments.

Our surgeons’ innovative techniques make healing from your surgery and living with your new organ as smooth as possible. However, receiving a lung transplantation requires lifelong follow-up care. Throughout your recovery and as you return to activity, our transplant team will stay in close contact with you to ensure postoperative success.

During the first year, you will be seen regularly to monitor your progress and for lab work to determine how well your lung is functioning. About half of all patients require readmission during the first year, usually to investigate the causes of fever or a change in lab test results. Our physicians are on hand to provide optimal care and get you back to normal life as soon as possible. As time progresses, you will be seen less frequently, but our team will always be here to provide the support you need for years to come.

There are several steps you can take to manage your health. These include taking your medications on time and keeping your follow-up appointments. Control your blood pressure if you have high blood pressure and your blood sugar if you have diabetes. Maintain a healthy weight. Control your cholesterol. Be sure to call us with any questions or concerns.

After you go home from the hospital, follow-up care with your transplantation team is vitally important. You will go to appointments once a week for the first four to six weeks. After that, your appointments will become less frequent. In approximately six months, you can return to visiting your primary care doctor.

Call us if you ever run out of your medications, lose your medical insurance or are at risk of losing it, have a fever, feel unwell or if you plan on traveling to a remote destination. There are a number of lifestyle adjustments you will need to make, which include: get a medical alert tag, do not get live virus vaccinations, do not try to become pregnant or father a child without talking to your transplantation team first, do not change cat litter or bird cage linings, and garden with gloves on.