Lung Transplant Surgery and Recovery

A lung transplant is a major surgery that requires careful preparation and lifelong follow-up. At UT Southwestern, our lung transplant team combines clinical excellence with personalized support before, during, and after surgery.

What Can Patients Expect with a Lung Transplant?

Before a Lung Transplant

Before a lung transplant, patients undergo a detailed evaluation by a transplant team to determine whether they are good candidates for the procedure. This process includes:

• Medical tests
• Imaging tests, such as a chest X-ray or computed tomography (CT) scan
• Lung function assessments
• Review of mental and emotional health

Patients must also demonstrate a strong support system and a willingness to follow strict care guidelines after surgery.

Once approved, patients are placed on a national waiting list for donor lungs. During this waiting period, patients are monitored closely and may be encouraged to start pulmonary rehabilitation, eat a healthy diet, and avoid tobacco to stay as strong as possible for the surgery.

During a Lung Transplant

During the transplant, our surgical team puts the patient under general anesthesia so that they’re fully asleep and feel no pain. The surgeon removes the diseased lung through an incision in the chest, along the side of the chest, or in the armpit.

The surgeon then places the healthy, carefully evaluated donor lung into the patient’s chest cavity and attaches it to the trachea and appropriate blood vessels.

The transplant surgery typically takes four to eight hours.

After a Lung Transplant

Most patients begin their recovery in the intensive care unit (ICU), where they’re supported by a ventilator and IV medications. Once they are stable, they move to a regular hospital room and gradually begin physical activity with the help of therapists.

What Are the Dos and Don’ts After a Lung Transplant?

Successful recovery after a lung transplant depends not only on surgery but also on following key medical and lifestyle guidelines. Our care team provides detailed instructions tailored to each patient, but the following general dos and don’ts are important for everyone.

Do:

• Take all medications exactly as prescribed, including immunosuppressants to prevent rejection
• Attend all follow-up appointments and routine tests, such as blood work, chest X-rays, and lung biopsies
• Monitor lung function at home, as directed by the care team
• Contact the care team immediately if any signs of rejection appear, such as shortness of breath, cough, fever, or chest discomfort
• Follow food safety guidelines and eat a balanced, nutritious diet to reduce infection risk and support healing
• Exercise regularly through a structured program like pulmonary rehabilitation, as recommended by the care team
• Stay within a healthy weight range to reduce strain on the heart and lungs
• Practice good hygiene, including frequent handwashing and dental care
• Stay away from people who are sick and avoid crowds, especially in the first few months
• Wear sunscreen (SPF 50+), long sleeves, and a hat when outdoors, as immunosuppressants increase skin cancer risk
• Keep the incision clean and dry, and follow all wound care instructions

Don’t:

• Lift more than 5 pounds for at least six to eight weeks after surgery, or more than 10 pounds for six months after surgery
• Drive for at least six weeks after surgery due to medication side effects and to protect the surgical site
• Skip or adjust medications without doctor approval
• Take nonsteroidal anti-inflammatory drugs (NSAIDs), as they can harm the kidneys when taken with transplant medications
• Soak the incision site until the wound is fully healed
• Smoke or allow smoking at home
• Have reptiles, birds, or exotic animals as pets due to increased risk of infection
• Drink alcohol unless approved by the care team
• Get live vaccines unless approved by the care team
• Share utensils or personal care items, especially in the early months
• Ignore symptoms like fever, fatigue, or breathing changes – even mild ones
• Eat grapefruit, pomegranate, and papaya (or drink their juices), as they interfere with immunosuppressant drugs

How Long Do Patients Need a Caregiver After a Lung Transplant?

Most patients need a caregiver during the initial recovery period, which usually lasts at least three months. During this time, patients have frequent medical appointments, need help managing medications, and may still be regaining their strength. A caregiver’s support is especially important for:

• Attending follow-up visits
• Monitoring signs of infection or rejection
• Assisting with transportation, meals, and daily routines
• Helping with medication management and scheduling

Some patients may need support for longer, depending on how smoothly their recovery goes and whether complications arise.

What Lung Transplant Support Services Does UT Southwestern Offer?

The Transplant Support Group meets virtually on the third Wednesday of each month from noon to 1 p.m. for transplant patients and their families to share experiences. This group (led by a social worker) provides an emotionally supportive atmosphere in which attendees can assist each other in coping with the various issues that arise before and after transplantation. It also provides information on topics of special interest to transplant patients and their families. For example, the dietitian may conduct a group discussion on nutritional information.