Lung Transplants as a Treatment for COPD

This article was written by Kalli Mago.

Some people with severe chronic obstructive pulmonary disease (COPD) get a lung transplant to help. In a lung transplant, doctors remove a diseased lung and replace it with a healthy lung from an organ donor.

A single lung transplant means replacing one lung, while both lungs are replaced in a double lung transplant. Whether someone gets a single or double transplant often depends on how many donated lungs are available and how many people are waiting. Studies show that double lung transplants can have an increased chance of long-term success.¹

COPD is one of the most common reasons why people get lung transplants. From 1990 to 2017, people with COPD made up 36% of all lung transplants.¹

What are the risks and benefits of a lung transplant?

A lung transplant is a serious treatment option. If other treatments are not working, doctors may consider a transplant.

The biggest risk of a transplant is organ rejection. This means your immune system starts to attack the donated lung. Within five years of the transplant, rejection affects 40-60% of people.¹ Other risks include infections, cancer, cardiovascular disease, and complications from the surgery.²

One year after a lung transplant, 85% are still alive. After five years, the survival rate for people with COPD is 70.4%.¹

When a lung transplant is successful, it can lead to big improvements in lung function and quality of life.¹

Is a lung transplant right for me?

Doctors consider a lung transplant if they think the surgery is necessary and likely to be successful. The transplant is considered necessary in cases where someone may be unlikely to live at least two years unless they have a lung transplant. The transplant is likely to be successful if the person has a good chance of surviving at least five years after the transplant.¹

Doctors look at many factors to decide if a lung transplant is a good option. This includes:

• Age
• Weight
• Physical fitness
• Substance use, including drugs and alcohol
• Heart health
• Access to physical and emotional support
• Other health conditions that could affect the transplant¹

If you have questions about whether a lung transplant could be right for you, talk to your doctor.

There are several stages to the transplant process. Here is what the journey may look like:

1. Get approved for a lung transplant.
   First, you will need to apply to a transplant program. You will go through a long screening process. Doctors will ask about your medical history, such as whether you have any other illnesses and what surgeries you have had before. They will also run medical tests. These tests include lung function tests, blood tests, CT scans, and more. This process helps reduce the risks associated with a transplant.

2. Get listed with the United Network for Organ Sharing (UNOS).
   If you are approved for a lung transplant, you will be listed with UNOS. This organization helps match people who need a transplant with donated organs. Finding a matching organ depends on several factors, including blood type and body size.

   In 2023, 81.2% of people received a lung transplant within one year of listing with UNOS. A majority (62.6%) waited for less than three months.³ The wait time can depend on how urgent the transplant is and when a matching organ becomes available.

3. Have lung transplant surgery.
   Since you don't know exactly when a matching lung will become available, you need to be ready 24/7 once you are listed with UNOS. As soon as you are matched, the surgery will happen fast. You will arrive at the hospital, be prepared for surgery, and receive your lung transplant.

4. Recover from the transplant.
   After the surgery, you will recover in the hospital. Many patients stay in the hospital for two weeks after a lung transplant. During this time, health care providers will help you recover from surgery, manage your pain, and help you practice using your new lungs.

   Finally, when you are ready to go home, you will receive more information about medications, diet, exercise, and other things you should know as you continue to recover at home.

How soon will I see the benefits of a lung transplant?

A recent study found that lung transplants often help people breathe better within three months. Lung transplants have a similar impact on quality of life. The first year after a transplant, many people see improvements in different areas of life. Their symptoms may improve, along with their ability to engage in activity and their social and mental well-being.⁴

If you have severe COPD and no other treatment option has worked, it's possible that a lung transplant could help you breathe better for longer. While lung transplants carry some big risks, they can also make a big difference for your health. Talk to your doctor if you have questions about getting a lung transplant or any other treatment options for your COPD symptoms.