What Is a Lung Transplant?

Breathing is supposed to be background noise — something your body handles while you get on with your day. When lung disease advances far enough, though, breathing moves to the foreground: stairs become expeditions, conversations get interrupted for air, and oxygen tubing starts to set the borders of your world. A lung transplant is the operation offered at that point in the journey — surgery that removes one or both diseased lungs and replaces them with healthy lungs from a donor. This guide walks through what to expect, stage by stage, if that road is ever put in front of you.

Start with the video at the top of this page. "Lung Transplant Surgery" runs about four and a half minutes, and in it Dr. Chadrick Denlinger, a transplant surgeon at MUSC, describes what must take place when a patient receives a lung transplant. It's a surgeon's-eye summary — brisk, plain-spoken, and a useful map of the operation before you read the slower walk-through below.

The road that leads to a transplant

Nobody starts here. A transplant is considered only when lung disease is advanced, still progressing despite full treatment, and likely to shorten life — while the rest of the body is judged strong enough to come through major surgery and the medicines that follow it. The conditions that most often lead people to this conversation include advanced COPD, pulmonary fibrosis (scarring of the lungs), cystic fibrosis, and pulmonary hypertension — high pressure in the lungs' blood vessels that strains the heart.

Getting listed is itself a process, and it's worth knowing that going in. Expect a thorough assessment spread over multiple visits: lung and heart testing, scans, blood work, and conversations with surgeons, lung specialists, nurses, dietitians, and social workers. Some of that testing is about the lungs; much of it is about everything else — because the team has to be confident the whole of you can handle what comes after the operation, not just the operation itself. If you're listed, you then wait for a donor match, and waiting is measured in patience rather than in dates anyone can promise.

One lung, two lungs — or heart and lungs together?

Not every transplant looks the same, and your team will talk through which version fits your disease. Some patients receive a single lung; others receive both, which is the more common pattern for conditions affecting both sides, such as fibrosis or cystic fibrosis. A smaller group — people whose heart is failing alongside their lungs — are considered for a combined heart-and-lung transplant, the sister operation to the heart transplant covered elsewhere on this site.

The donor lungs, whichever pattern is chosen, come from a person who has died and whose lungs can be given through organ donation, matched to you on factors such as blood group and chest size. And because a donor lung stays usable for only a limited time once it's removed, the call — when it comes — tends to come without ceremony, often in the middle of the night: come to the hospital now.

The day itself: what to expect

You'll be fully asleep under general anaesthesia, and you'll wake up in intensive care — that's planned, not a complication. Through an incision in the chest (under the breastbone area, or across the front of the chest for a double transplant), the surgeon removes the diseased lung and connects the donor lung in its place: the airway, and the blood vessels that carry blood into and out of the lung, are joined with fine stitching. Some operations use a heart-lung machine to support circulation during the surgery; others are done while your own heart keeps working, sometimes with smaller support devices. If both lungs are being replaced, they're usually done one side at a time.

In intensive care you'll be on a ventilator at first — a machine breathing for you through a tube while the team watches the new lung settle in. Tubes and drains around the chest, close monitoring, and regular chest imaging are all part of those first days. The breathing tube typically comes out once you're awake enough and the new lung is doing its job; from there, the work shifts to sitting up, standing, and walking the ward a little further each day.

For a shorter companion view filed under the same search, the clip "External breathing lung transplant" is also on this site.

The first weeks, and the years after

Recovery is a slope, not a switch. Most people spend days in intensive care and a few weeks in hospital altogether, then continue building strength at home with pulmonary rehabilitation — supervised exercise and breathing work that helps you actually use the capacity the new lung gives you. Follow-up is frequent at first: clinic visits, lung-function tests, blood work, chest imaging, and sometimes bronchoscopy — a camera look into the airways — to check on healing and catch problems early.

One part of transplant life never graduates: medication. Because a donor lung is foreign tissue, you'll take anti-rejection (immunosuppressant) medicines every day for as long as the transplant lasts, to keep your immune system from attacking it. The trade-off is that those medicines also make infections easier to catch, so recipients learn a new attentiveness — fevers and new coughs get reported early, vaccinations stay current on the team's advice, and crowded indoor air during flu season gets a second thought. It becomes routine. And for most recipients, the exchange is measured in ordinary miracles: walking to the mailbox without stopping, sleeping through the night, planning a day around something other than oxygen.

References & further reading

• MedlinePlus — Lung Transplantation: https://medlineplus.gov/lungtransplantation.html
• MedlinePlus Medical Encyclopedia — Lung transplant: https://medlineplus.gov/ency/article/003010.htm
• NHS — Lung transplant (Organ transplantation, NHS Blood and Transplant): https://www.nhs.uk/conditions/lung-transplant/
• MedlinePlus — COPD: https://medlineplus.gov/copd.html

Frequently Asked Questions

Can you live with just one transplanted lung?
Yes — single-lung transplants are a long-established version of this operation, and one healthy lung can do the breathing work the body needs. Whether one lung or two are used depends on the disease being treated and on the surgical team's judgement for your case.

How long do you stay on a ventilator afterwards?
It varies. The ventilator supports you through the operation and the earliest recovery, and the tube is removed once you're awake and the new lung is working well on its own — sometimes quickly, sometimes after a longer, more gradual wean in intensive care.

What is rejection, and how would I know?
Rejection is your immune system recognising the donor lung as foreign and attacking it. It doesn't always cause symptoms early on, which is exactly why follow-up includes scheduled lung-function tests, imaging, and sometimes bronchoscopy with small tissue samples — the team aims to catch it before you feel it.

Will I still need oxygen after a transplant?
The aim of the operation is breathing without supplemental oxygen, and many recipients reach that as they recover. Progress is gradual, though — expect to rebuild distance and stamina over weeks to months with rehabilitation rather than all at once.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Educational only — this article is general information about lung transplantation, not medical advice and not a diagnosis. Whether a transplant is appropriate, and how a candidacy is assessed, belongs to your own lung and transplant team.