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Lung Transplantation

Updated : December 24, 2025

Lung transplant is treatment for advanced lung disease. Lung transplants save patients with end-stage lung disease unresponsive to alternative treatments.

Lung transplantation improves the quality of life for patients with end-stage respiratory failure that does not respond to treatment. Dr. James Hardy performed first human lung transplant in 1963.

Types of Lung Transplants as follows:

Single-Lung Transplant

Double-Lung Transplant

Living donors provide lower lobes for bilateral implantation in transplantation.

Criteria for donor lungs include:

Donor age between 18 to 55 years old

No history of smoking or minimal smoking history

No significant lung disease/infection

Blood type compatibility with the recipient

Lung transplant is treatment for advanced lung disease. Lung transplants save patients with end-stage lung disease unresponsive to alternative treatments.

Lung transplantation improves the quality of life for patients with end-stage respiratory failure that does not respond to treatment. Dr. James Hardy performed first human lung transplant in 1963.

Types of Lung Transplants as follows:

Single-Lung Transplant

Double-Lung Transplant

Living donors provide lower lobes for bilateral implantation in transplantation.

Criteria for donor lungs include:

Donor age between 18 to 55 years old

No history of smoking or minimal smoking history

No significant lung disease/infection

Blood type compatibility with the recipient

Causes of respiratory failure in patients with advanced-stage pulmonary disease are as follows:

Chronic Obstructive Pulmonary Disease

Pulmonary Arterial Hypertension

Sarcoidosis

Bronchiectasis

Idiopathic Pulmonary Fibrosis

Cystic Fibrosis

Interstitial Lung Diseases

Absolute Contraindications as follows:

Significant Cardiovascular Disease

Active or Recent Malignancy

Uncontrolled Infection

Significant Liver or Kidney Dysfunction

Active Substance Abuse

Relative Contraindications as follows:

Age and Body Mass Index

Colonization with Resistant Organisms

Mechanical Ventilation

Lung transplant recipients have better one-year survival rates of 80% to 90%. Lung transplant recipients see increased survival rates post five years.

Lung transplants improve quality of life for recipients with severe lung disease. Benefits include increased exercise capacity, reduced symptoms, and better ability to do daily tasks.

Lung function improves after transplantation, but decline can occur due to rejection.

Lung transplant patients experience enhanced exercise capacity and endurance for improved physical activity ability.

Surgical Instruments:

Chest Tubes and Drainage Systems

Anastomosis Equipment

Anesthesia Equipment

Monitoring Equipment

Cardiopulmonary Bypass and ECMO Equipment

Informed Consent:

Educate patients and their family on procedure, risks, benefits, and post-transplant regimen importance.

Patient Positioning:

Patients receive general anesthesia, intubation, and mechanical ventilation during surgery.

Patient positioned on side for single-lung transplant or back with arms extended for double-lung transplant.

Donor Lung Harvesting:

Donor lungs are removed and preserved before being transported to the transplant center for surgery.

Anatomy of lung

For Single-Lung Transplantation:

Step 1: Excision of Diseased Lung

Incision made on chest side between ribs for thoracotomy.

Recipient’s diseased lung removed with careful dissection, clamps, and vessels cuts.

Step 2: Implantation of Donor Lung

The donor lung is placed in the chest cavity and connected through surgical connections as:

The donor pulmonary artery connected to recipient, then donor pulmonary veins connected to recipient left atrium, and finally donor bronchus connected to recipients.

Step 3: Reperfusion

The transplanted lung receives blood flow and ventilation. Sutures or staples are used to close the chest, with chest tubes inserted for drainage.

For Double-Lung Transplantation:

Step 1: Excision of Diseased Lung

Surgical incisions were made to access both lungs during medical procedures.

Recipient undergoes bilateral lung removal surgery, with clamps and cutting of blood vessels.

Step 2: Implantation of Donor Lung

Donor lungs implanted sequentially with same anastomoses as single-lung transplantation.

Step 3: Reperfusion

The transplanted lung receives blood flow and ventilation. Sutures or staples are used to close the chest, with chest tubes inserted for drainage.