Lung Disease and Transplant: General Information

A lung transplant is surgery that removes a patient’s unhealthy lung (or lungs) and replaces it with:

• A healthy lung from a donor (usually deceased)
• Part of a healthy lung (from a living donor)

Most patients replace both lungs in a transplant surgery (double lung transplant). Some patients have:

• Surgery to replace only 1 lung (single lung transplant)
• More than one lung transplant surgery

Usually, patients need a lung transplant if they have: 

• Pulmonary fibrosis
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• Pulmonary hypertension
• A different disease that affects their lungs

Age guidelines

• Anyone (newborn to adult) can have a lung transplant
• Some guidelines say lung transplant patients should be younger than 65
• Many patients over 65 do have lung transplants
• Usually, patients over 75 do not qualify, but transplant centers make the final decisions

Lung Transplant Waitlist

A patient is put on the transplant waitlist when their transplant team decides they meet requirements for lung transplant.

The treatment team gives the patient a Lung Allocation Score (LAS) to predict how long the patient:

• Can live without a lung transplant
• Might live after lung transplant surgery

A higher LAS score means the patient is higher on the lung transplant waitlist, so they will get a lung transplant sooner. 

Learn more about LAS scores: 

• United Network for Organ Sharing (UNOS) “A Guide to Calculating the Lung Allocation Score”
• Organ Procurement and Transplantation Network (OPTN) LAS Calculator

Donor Lungs

Transplant centers use ex-vivo lung perfusion (EVLP) so they have more donor lungs they can use for transplant. 

EVLP is technology that circulates a solution (nutrients, proteins, and oxygen) through donor lungs to: 

• Evaluate their health
• Improve their health
• Reverse lung damage

Ask your transplant team about donor lungs from increased-risk donors. 

• Patients who accept organs from increased-risk donors usually wait less time for an organ
• An increased-risk donor is a deceased donor with higher risk of spreading one of the following undiagnosed diseases to a transplant patient (Abara et al., 2019):
  • Human immunodeficiency virus (HIV)
  • Hepatitis B, or 
  • Hepatitis C (HCV)
• Organs from increased-risk donors are not lower quality