Who Needs a Lung Transplant?

Your doctor may recommend a lung transplant if you have severe lung disease that's getting worse. If your condition is so serious that other treatments don't work, lung transplant may be the only option.

Lung transplants most often are used to treat people who have severe:

• COPD (chronic obstructive pulmonary disease). This is the most common reason in adults for needing a lung transplant.
• Cystic fibrosis. This is the most common reason in children for needing a lung transplant.
• Idiopathic pulmonary fibrosis.
• Pulmonary hypertension.
• Alpha-1 antitrypsin deficiency.

Applying to a Lung Transplant Program

Lung transplants are done in medical centers (large hospitals) where the staff has a lot of organ transplant experience. If you need a lung transplant, you must apply to a center's transplant program.

Transplant teams at the medical center manage all aspects of the center's transplant program. Transplant team members may include a:

• Thoracic (THOR-as-ik) surgeon. This is a doctor who performs lung and chest surgery.
• Pulmonologist. This is a doctor who specializes in lung diseases and conditions.
• Cardiologist. This is a doctor who specializes in heart diseases and conditions.
• Respiratory technician. This is a person who cares for people who have breathing and lung problems.
• Transplant coordinator. This is a person who arranges the surgery.

Other team members may include a social worker, psychiatrist, financial coordinator, and other specialists and medical personnel, such as a nutritionist and nurses.

The transplant team will need to find out whether you're a candidate for lung transplant. They will want to make sure you're healthy enough to have the surgery and go through a recovery program afterward.

To do this, they will ask about your medical history. The team will want to know whether you have other serious illnesses or conditions, such as cancer, HIV, or hepatitis. They also will ask whether you've had a major chest surgery before. A previous chest surgery may make it hard to do a lung transplant.

The team also will want to know whether you smoke or use alcohol or drugs.

You also will have tests to determine whether you're healthy enough for a lung transplant. Tests may include:

• Lung function tests. These tests measure the size of your lungs, how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood.
• Blood tests. Blood tests help doctors check for certain diseases and conditions. They also help check the function of your organs and show how well treatments are working.
• Chest CT scan. This test creates precise pictures of the structures inside your chest, such as your lungs.
• EKG (electrocardiogram). This test detects and records the heart's electrical activity.
• Echocardiogram. This test uses sound waves to create pictures of your heart.
• Right cardiac catheterization. This test measures blood pressure in the right side of your heart. The results give clues about heart valve disease, heart failure, or lung problems.

You'll talk with team members to make sure you're mentally and emotionally willing to accept the risks of the transplant process and later treatment. The team may ask whether you have a good support network of family and friends.