What is a lung transplant?
In simplest terms, a lung transplant involves taking the lungs from someone who has passed away and putting them into someone else whose lungs need to be replaced. It sounds simple, but it takes a tremendous amount of coordination to make it all happen and it is a major operation.
It is a complex procedure that involves a lot of coordination. Timing is also important. Pulmonologists don’t want to plan for the procedure too early or too late. And, transplant depends on having an available donor.
Yet, a lung transplant can be a life-changing event. Individuals often go from being homebound to getting back to skiing or golfing and traveling the world. They have a second chance at life, and a good quality of life. In some cases, a transplant can give someone an extra 10 or even 30 years.
How much better and how much longer life can be with a transplant depends on both how well things go after the transplant, as well as how poorly things would have gone without the transplant. Healthier people often do better after a transplant, but they also would have done better without the transplant compared to people who are in worse health.
When is a lung transplant needed?
The conversation about when a lung transplant is needed is tailored to each individual. As a rule of thumb, if you’re on oxygen, it’s probably not too early to start thinking about a transplant. Having a high carbon dioxide level or getting admitted to the hospital for a COPD exacerbation are other reasons to talk to a pulmonologist about whether a transplant may be something to think about in the future.
Unfortunately, patients can deteriorate quickly. Timing the transplant correctly can be challenging. It is similar to Goldilocks and the Three Bears – you don’t want to be too early; you don’t want to be too late. The transplant team aims to be just right.
Doctors don’t want to transplant people before they need it, but it does take a lot of time to get through the necessary evaluation process. It takes a lot of time once someone’s listed for a transplant for the transplant team to review donors and finally get a good donor that will do well for an individual person. When people are really sick and they come in and don’t have a lot of time, the team doesn’t have an opportunity to work with them to get them ready for a transplant; it’s a lot more risk when it happens that way. The transplant team prefers to get people a little earlier in the process, so they have time to work on them and get them optimized to make sure the procedure is done as safely as possible.
How to get referred for a lung transplant
Patients are most often referred by their health care provider with whom they can have an open conversation since they already have a good relationship. Sometimes the provider might advise against a transplant for a reason, such as the patient is still smoking or has a weight issue. Usually, the lung transplant team can work with a patient on those concerns. Sometimes the team can get the person healthy enough that they no longer need a transplant.
Not all providers are knowledgeable in lung transplants, so it’s important for individuals to advocate for themselves. If you believe yourself to be a candidate, ask for a referral to a pulmonary expert. A transplant could make all the difference in the world.
Lifestyle interventions matter
The good news is, sometimes all it takes is getting “healthier” to ease symptoms. For example, quitting smoking and losing weight.
At the University of Maryland Medical System, resources exist to help people quit smoking. This includes dedicated smoking cessation clinics. Oftentimes, people need guidance along their smoking cessation journey. Experts can help individuals navigate through withdrawal symptoms. Most people who give enough effort and time can ultimately quit smoking. If they are persistent and stick with it, most people can quit. In fact, if someone can quit smoking for at least six months, most of the time they won’t go back.
If someone needs a transplant, not smoking is not just something that is good for the lungs and heart or any aspect of post-transplant health but is a way to honor the donor who gave them a second chance at life.
A word on organ donation
Transplantation begins with the decision to donate. Organ donation can often be the only good thing that comes from a tragedy for families facing the loss of a loved one. A single donor can save eight lives and help dozens more. Without donation, a transplant can’t happen. If you have questions about organ donation, your health care provider is a great place to start.
Listen to a podcast
COPD and Lung Transplants: When and How to Advocate for Yourself
COPD can take a toll on your lungs and sometimes a lung transplant is the best option. Unfortunately, patients often wait too long to get the lung transplant they need. In this podcast, Dr. Robert Reed, Medical Director of the University of Maryland Lung Transplant Program, addresses what signs to look for that indicate a lung transplant might be beneficial, how to advocate for yourself to get the care you need in a timely fashion and the benefits of getting a lung transplant. Listen here or below.
More to Read
- Why (and How) to Quit Smoking
- Build an Action Plan for COPD Flare-Ups
- COPD Warning Signs
- COPD in Women and Underserved Populations
Medically reviewed by Robert Reed, MD.
