Froedtert & the Medical College of Wisconsin Froedtert Hospital offers all treatments for lung disease, including lung transplant. This includes expert, compassionate support for you and your family in your commitment to the post-transplant care regimen required to live life to the fullest.
Goals of Lung Transplant
When you and your pulmonologist agree that your quality of life and ability to survive can no longer be enhanced by other treatment options, it is time for a transplant. A lung transplant not only offers the chance to save a life, but also the opportunity to extend it. The lung transplant process aims to restore good lung function, free you from supplemental oxygen use, improve quality of life, provide opportunities for months and years gained, and focus on daily activities of life rather than on your illness.
The Lung Transplant Evaluation
To confirm that you are a good candidate for transplant, transplant team members thoroughly evaluate your physical, mental and social (lifestyle) health. Screenings look for infections or viruses that could compromise transplant after the fact when the immune system is weakened due to antirejection medications. The health of the heart and other body systems are assessed and a lung biopsy may be requested. The team also assesses your cultural and spiritual needs, support systems and psychological readiness.
Preparing for Lung Transplant Surgery
Once accepted for transplant and given a lung allocation system (LAS) score, the lung transplant care team helps you achieve the optimal level of health possible. This may include antibiotics to clear infection. All patients participate in our pulmonary rehabilitation program to increase strength and endurance prior to surgery. You and your family learn what to expect before, during and after the procedure. They consult with experts on the team, including social workers, registered dietitians, pharmacists, case managers, psychologists, financial counselors and physical and respiratory therapists. In addition we offer several resources to help you on your transplant journey, including a dedicated pre-transplant coordinator, education and support services and a mentor program.
Lung Transplant Surgery
Generally, lung transplant surgery lasts 6 to 12 hours. The surgical team includes lung surgeons, anesthesiologists, advanced practice providers, nurses and technicians — all specialists in lung transplant. When you arrive at the hospital for a lung transplant, you will be taken to the operating room by the anesthesia team. The anesthesia team places an IV to give general anesthesia and places a breathing tube. Once you are asleep with the breathing tube in place, surgery will begin. If required, the surgeon may place you on a cardiopulmonary bypass machine (heart-lung machine) to maintain circulation and provide oxygen to the body during the surgery.
For a single-lung transplant, an incision is made in between the ribs (thoracotomy), whereas during a bilateral (double) lung transplant the incision is made across the entire chest (clam-shell incision) to expose the lung cavities. The diseased lung(s) are carefully removed and the healthy donor lung(s) are put in place. The surgeon then attaches the blood vessels and airways to the new lung(s) and disconnects the heart-lung machine, if in use. With the donor lung(s) in place and connected, the incision is closed. Two chest tubes are placed in each lung space to drain air, fluid and blood so the new lung(s) can expand fully.
If you need circulation and oxygenation support immediately after transplant, you may be placed on temporary extracorporeal membrane oxygenation (ECMO). In this case, you would continue to have a breathing tube and be connected to a heart-lung bypass machine while transferred to the intensive care unit (ICU).
Recovery from Lung Transplant Surgery
After lung transplant surgery, you will stay in the intensive care unit for several days, and then move to a special surgical unit for transplant patients. There, they recover and rehabilitate for for 2 to 3 weeks on average. Once home, most patients continue pulmonary rehabilitation to increase stamina and strength. Frequent visits to the transplant clinic for evaluation and testing are required during the first year to monitor the recovery process, medications and overall health. During this time and for the rest of the your life, our care team is just a call away when questions or concerns develop.
Life-Long Commitment Required for Success
The full potential benefits of lung transplant cannot be achieved without a commitment to rigorous follow-up care to help monitor and manage changes in physical health, stamina and lifestyle after lung transplant. This requires at least quarterly clinic visits and lab work. It also may include treatment for other conditions that can develop after lung transplant, including high blood pressure, kidney dysfunction, high cholesterol, diabetes, skin cancer and gastrointestinal problems. While a concern, these conditions are treatable.
Through the lung transplant process, you will come to know and trust our transplant coordinators, forming a bond that lasts a lifetime. Coordinators help patients and their families navigate life after transplant, working together to monitor their conditions, handle daily routines, manage antirejection medications, treat infections and arrange treatment for any new transplant-related medical developments that may arise. They help keep you on track with routine appointments, testing and medications, so they stay as healthy as possible after lung transplant.
For more information about the lung transplant process, see our FAQ.