Lung transplant is surgery to replace one or both diseased lungs with healthy lungs from a human donor.

A lung transplant is usually the last resort treatment for lung failure. The new lung or lungs are donated by someone who has been declared brain-dead but remains on life-support. The donor tissue must be matched as closely as possible to that of the recipient to reduce the odds that the transplanted tissue will be rejected.

While the recipient is unconscious and pain-free (general anesthesia), an incision is made in the chest. Tubes are used to re-route blood to a heart-lung bypass machine to provide oxygen and move blood through the body during the surgery.

One or both of the patient's lungs are removed, and the donor lung or lungs are stitched (sutured) into place. Chest tubes are inserted to drain air, fluid, and blood out of the chest for several days to allow the lungs to fully re-expand.

Sometimes heart and lung transplants are done at the same time (heart-lung transplant), if the patient's heart is also diseased.

Lung transplants may be recommended for patients with any severe lung disease. Some examples of disease that may require lung transplant are:

• Cystic fibrosis
• Emphysema
• Idiopathic pulmonary fibrosis
• Sarcoidosis

Lung transplant is not recommended for:

• Patients who are too sick to go through the procedure
• Patients whose lung disease will likely affect the new lung(s)
• Patients who have severe disease of other organs

Risks for any anesthesia are:

• Breathing problems
• Reactions to the medications

• Bleeding
• Infection

• Blood clots (deep venous thrombosis)
• Infections due to anti-rejection (immunosuppression) medications

Lung transplant is an extreme measure for patients with life-threatening lung disease or damage. Survival rates are high at 1 year following the transplant but are somewhat lower at 4 years.

Fighting rejection is an ongoing process. The body's immune system considers the transplanted organ as an invader (much like an infection) and may attack it.

To prevent rejection, organ transplant patients must take anti-rejection (immunosuppression) drugs (such as cyclosporine and corticosteroids) that suppress the body's immune response and reduce the chance of rejection. As a result, however, these drugs also reduce the body's natural ability to fight off infections.

Patients should expect to stay in the hospital for an extended period of time. The recovery period is about 6 months. Patients will need to have regular check-ups with blood tests and x-rays for many years.