Lung Transplant — Procedure Guide, Recovery & Risks | MyMedicPlus

Lung transplantation replaces one or both diseased lungs with healthy donor organs to restore respiratory function in end-stage pulmonary disease. Bilateral transplantation is preferred for most indications due to better long-term survival.

Indicated for COPD (FEV1 below 20% predicted), idiopathic pulmonary fibrosis, cystic fibrosis, pulmonary arterial hypertension, and alpha-1 antitrypsin deficiency with projected 2–3 year survival below 50%.

Under general anaesthesia, diseased lung(s) are removed via thoracotomy or clamshell incision. Donor bronchus, pulmonary artery, and veins are anastomosed in sequence. CPB or ECMO maintains circulation throughout.

ICU stay is 1–3 weeks; total hospitalisation 3–6 weeks. Immunosuppression starts immediately. Pulmonary rehabilitation begins within days of extubation. Full functional recovery takes 6–12 months guided by spirometry.

Primary graft dysfunction affects 25%; acute rejection 35% within the first year; chronic lung allograft dysfunction (BOS) 50% at 5 years. Opportunistic infections and calcineurin inhibitor-related renal failure are common.

Median survival is approximately 6 years (bilateral) and 4.5 years (single). ISHLT registry data show 80% 1-year and 54% 5-year survival. Quality of life improves significantly within 3–6 months of transplantation.