Lung Transplant

What is a lung transplant?

A lung transplant is a type of surgery that may be an option for certain people with severe chronic obstructive pulmonary disease (COPD). A lung transplant involves removing one or both of a patient’s lungs. One or both lungs are then replaced with another person’s lung or lungs, which are called donor organs. Over 70% of lung transplants in people with COPD are double-lung transplants.1

Lung transplants are usually only an option for those with a very advanced stage of COPD. When patients decide to go forward with a lung transplant, they may have to wait until exactly the right match of donor lungs becomes available. There are far fewer donor organs available than there are patients who are waiting for them. This means that the waiting list for a transplant can be very long.1

What characteristics make someone a good candidate for a lung transplant?

A lung transplant is a major surgical operation that is not suitable for all COPD patients. There are major risks involved, so it is important to make sure that the possible benefits of a lung transplant far outweigh the risks. Patients and their healthcare providers will carefully consider whether a lung transplant is the best choice.1,3

Lung transplants are usually given to patients who are less than 65 years of age, as well as those who have:

  • Severe or end-stage COPD
  • Very low lung function measured by spirometry
  • History of exacerbations that cause high levels of carbon dioxide in the blood1,3

There are many reasons why lung transplants are not suitable for most COPD patients. For instance, the patient’s lung disease might not be severe enough. Patients who are candidates for a lung transplant must usually have predicted FEV1 of less than 20%, measured by spirometry. This means their lungs are functioning at a very low capacity.1,3

To undergo lung transplant surgery, the patient’s body must also be strong enough to go through such a major surgery. For this reason, the patient’s other organs, such as the heart or liver, need to be functioning well enough for surgery. The patient cannot be a current smoker.1,3

What are the possible benefits of a lung transplant for COPD patients?

A lung transplant can provide positive results for certain people with severe COPD. These include:

  • Improved lung function
  • Increased ability to exercise
  • Better quality of life3

The patients who benefit the most from a lung transplant are strongly motivated to receive the transplant and improve their health. Patients are often asked to complete a special pulmonary rehabilitation program before the surgery, to help prepare them for the transplant. They also need to have a strong support network to help them cope with the stresses of waiting for the transplant, undergoing surgery, and recovery after the surgery.3

What are the risks linked to lung transplants?

Any kind of organ transplant, such as lung transplants, runs the risk of the patient’s body rejecting the new organ. This means that the body reacts badly to the new lung/lungs in a way that can cause very serious complications, including death. People with COPD who have had lung transplants also have a greater risk of getting serious fungal and bacterial infections.2,3

Written by: Anna Nicholson and Emily Downward | Last reviewed: April 2018.
View References
  1. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease, 2018 Report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Available at http://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf. Accessed 4/3/18.
  2. American Lung Association. “Surgery.” Available at: http://www.lung.org/lung-disease/copd/treating-copd/surgery.html [Accessed 1 March 2015.]
  3. Huang M and Singer L. “Surgical Interventions for COPD.” Geriatrics and Aging. 2005;8(3):40-46.