Because each individual's situation is unique, we will address this important issue in the broadest terms. Patients are given many opportunities to discuss their needs and concerns with experienced physicians and caregivers during visits to the transplant center. The following general information usually applies.

Lung transplant recipients usually stay in the hospital for three to four weeks. Education and physical rehabilitation begin soon after surgery and continue in the outpatient pulmonary transplant rehabilitation program after the patient leaves the hospital.

In the early post-hospital phase, your transplant team will probably see you several times a week; eventually these visits decrease to one per month. Transplant recipients will be asked to remain in the Twin Cities area for two to three months following transplantation, to allow us to closely monitor your status. Transplant recipients and their families participate in educational activities to help them feel comfortable with taking medications, monitoring blood pressure and measuring lung function.

Post-Transplant Immuno-suppression

Daily and lifelong immuno-suppressive medication is required to prevent rejection of the transplanted lung. The threat of acute rejection is highest in the first six months after surgery. To screen for signs of rejection, transplant patients undergo routine chest X-rays and lung function measurements such as spirometry and pulse oxymetry.

If organ rejection is suspected, samples of lung tissue are tested to determine whether rejection has begun or another problem, such as an infection, is developing. This procedure is called a bronchoscopy with trans-bronchial biopsies. Lung transplant patients undergo screening bronchoscopies and biopsies at one, three, six and 12 months after transplantation and when necessary if signs of rejection are present. These procedures are done under sedation to avoid discomfort.

Most patients are treated with three immunosuppressive drugs to prevent rejection. These medications usually require frequent adjustments, especially soon after transplant. These medications must be given in doses high enough to avoid acute rejection but not so high that the patient becomes vulnerable to infections. Because the likelihood of developing infections soon after transplant is high, patients also are given protective antibiotics to prevent the most common infections that occur after transplant. After a few months, as the body becomes more tolerant of the newly implanted lung, doses of immunosuppressive drugs are progressively lowered, and that makes it possible to slowly discontinue protective antibiotics.

Once transplant recipients' health is stable and they have returned home, they should see their primary care physician regularly. They should test their lung volume with a portable spirometry device every day. Each transplant patient is given the necessary equipment and is instructed in its correct use. These measurements provide important and objective information about how well the lungs are working. A decline in the measurements is a signal that patients should be evaluated.

The lung transplant team continues to care for transplant patients in coordination with their primary care physicians.

Long-Term Health Issues and Complications of Lung Transplantation

Additional complications of lung transplantation, usually caused by side effects of immunosuppressive therapy, include high blood pressure, poor kidney function, weak bones (osteoporosis), weight gain and diabetes. Medications are available to help manage these problems, but a healthy lifestyle, proper diet and exercise are equally important prescriptions for transplant patients.

Lung function is also monitored to identify and treat possible chronic rejection, also called bronchiolits obliterans, which is characterized by slowly progressive breathlessness.

Immunosuppressive therapy also makes transplant recipients more prone to developing tumors and cancer. Therefore, a healthy lifestyle, proper diet, strict avoidance of tobacco products and regular checkups to screen for common preventable cancers, such as breast, cervix, colon, and prostate, are important.