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Lung Transplants

Guide to Lung Transplants for COPD

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Updated June 10, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Lung transplants are indicated for people with COPD who are in the very advanced stages of the disease and who meet very specific criteria. If you are an individual with COPD who has tried every avenue of treatment, both medically and surgically, and you continue to deteriorate, you may be eligible for a referral for lung transplantation.

Benefits of Lung Transplants

Lung transplants have been shown to improve quality of life and the ability to perform physical activities related to muscle strength. While they do not, as of yet, increase long-term survival in COPD, short-term survival continues to improve. In fact, in a 2005 survey of patients who had single-lung transplants, the National Heart, Lung and Blood Institute reports that:

  • More than 82% of patients survive the first year after a transplant
  • Approximately 60% survive 3 years after a transplant
  • More than 43% survive 5 years after a transplant

As surgical procedures and technology improve, perhaps one day, long-term survival will be possible.

Who Qualifies for a Lung Transplant?

To be referred by your doctor for a possible lung transplant, you should meet the following criteria:

  • be less than 65 years of age (although some programs will consider older patients)
  • have an FEV1 of less than 20% predicted (although some programs accept an FEV1 that is higher, depending upon the circumstances)
  • have chronic hypercapnia and a lowered Pa02 as measured by arterial blood gases
  • have secondary pulmonary hypertension
  • have a BODE Index score of > 7
  • your chances for survival should be greater if you have a lung transplant, than if you don't
Potential transplant patients should also be ambulatory, not be overweight or underweight, be highly motivated and have an excellent support system.

What if I've Had Previous Lung Surgery?

Having had previous lung surgery such as lung volume reduction surgery (LVRS) or bullectomy does not disqualify you from having a lung transplant. In some patients, prior lung surgery can actually work in their favor.

Complications of Lung Transplant

Apart from the possibility of death during the operation, complications of lung transplants include:

Risk Factors for Complications After Lung Transplant

There are many factors that may contribute to a poor outcome in lung transplant surgeries, including smoking, poor baseline health, increased age, obesity and the severity of your disease. Your doctor will review these risk factors with you very carefully, to make sure that the benefits of the surgery outweigh the risks.

To see a step-by-step photo guide to lung transplant surgery, visit the Lung Transplant Image Gallery.

Sources:

Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2010. Available from: http://www.goldcopd.org.

Merlo, Christian A; Orens, Jonathan B. Selection of candidates for lung transplantation. Current Opinion in Organ Transplantation: October 2007. Volume 12. Issue 5. pages 479-484.

National Heart, Lung and Blood Institute. What are the Risks of Lung Transplants? Dec. 2008.

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