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What to expect before and after lung transplant
1. What To Expect Before and After
Lung Transplant
Prepared By: Sandra Tindle, RRT
Cardiac/Pulmonary Rehabilitation
Coordinator
2.
3. Before Lung Transplant
• You will be referred to see the transplant
pulmonologist by your doctor.
• You may have many appointments with the
transplant pulmonologist before he decides
that you are ready for the surgery.
• You will be expected to go through a rigorous
evaluation process.
5. Transplant Evaluation
• The transplant evaluation usually takes 3-7
days.
• You will meet the entire transplant team: nurses,
surgeons, doctors, therapists, and social workers.
• The transplant pulmonologist orders the testing
that he thinks you need to have during the
evaluation. This usually depends on age and the
disease you have.
• Usually consists of blood work, x-rays, echo, heart
cath, ABG, 6 minute walk test, liver and bone
scans, and PFTs.
7. Pulmonary Rehab
• You will be enrolled in a Pulmonary Rehab
program, if you aren’t already enrolled in one.
• You will be monitored during exercise and be
placed on O2 if needed.
• You will be instructed on breathing exercises and
coordinated breathing.
• You should be instructed on exercises for muscle
strengthening, flexibility, and endurance.
• Rehab sessions should meet for a minimum of 3
times per week, preferably 4-5 times per week.
9. In The Hospital
• After surgery you will be taken to the SICU.
• You will probably still have a tube in your mouth.
• You will probably still be on the ventilator.
• You will have tubes in your chest to drain
air/fluid.
• You will have a catheter in your bladder.
• You will have a catheter in your wrist to monitor
blood pressures.
10. In The Hospital
• If you’re having a single lung transplant, your
incision will be on your side.
• If you’re having a double lung transplant, your
incision will be just at the base of your breast.
• You will stay in SICU for 2-7 days after surgery.
• You will be visited by respiratory therapists,
pulmonary rehab, and physical therapy. These
specialists will help you to keep your strength
and mobility while recovering.
11. In The Hospital
• Once you have moved out of SICU and into a regular
room, someone from the team will be in to visit with
you everyday to teach you and your caregivers how to
take care of your new lungs and how and when to take
your new medications.
• You will be given a spirometer to monitor you lung
function twice every day.
• You will also have at least one bronchoscopy. This
procedure allows the doctor to place a camera in your
lungs, and also to take samples of tissue from the lungs
to look for viruses or rejection.
• Most people are discharged 1-4 weeks after transplant.
12. After Discharge
• You and your caregiver will need to stay close to
your transplant center for at least 3 months after
transplant. How close depends on what your
center deems as acceptable.
• Vanderbilt patients must stay within 10 minutes
of Vanderbilt.
• You will need a backup caregiver in case you first
caregiver has an emergency and isn’t available.
• You will have to go through much testing during
the first 3 months after transplant.
14. After Discharge
• Transplant is a life long commitment.
• You will need to take your medications on a set
schedule. Set an alarm so you don’t miss them.
• You may have to change your diet to fit your
nutritional needs.
• You may have to change your habits: buffet
restaurants may be out of the question, as well as
meat that isn’t cooked to the recommended
temperature. You may also have to stop drinking
fountain drinks.
15. Anti-Rejection Medications
• Prograf: take twice/day at the same times every day.
Side effects: toxic on kidneys, increased BP, swollen or
bleeding gums, shaky hands.
• Cellcept: take twice/day at the same times every day.
Side effects: infection, mouth sores, anemia,
nausea/diarrhea, hair loss
• Prednisone: prevents inflammation. Side effects:
weight gain, indigestion, acne, slower healing, mood
swings, insomnia, increased blood sugars.
• Cyclosporine: prevents rejection. Side effects: tremors,
headache, dizziness, insomnia, nausea, high blood
pressure.
17. Preventive Medications
• Bactrim: prevents pneumonia and treats infection.
• Inhaled amphotericin lipid complex: prevents fungal
infection.
• Anti-reflux: you will be on one type of this medication
for the rest of your life, even if you don’t have reflux
problems now. This helps prevent your new lungs from
problems with reflux in the future, possibly due to new
meds.
• You will be on medication to prevent certain types of
viral infections.
• Nystatin: prevents thrush
• Lasix: prevents fluid buildup.
18. Preventive Medications
• Sporanox: prevents fungal infections.
• You will also take calcium and magnesium and vitamin
D because prednisone affects the calcium stored in the
body.
• Anti-hypertensives: you will probably need to take a
medication to lower your BP at some point since the
anti-rejection meds can cause you to have a high BP.
• There are many, many OTC medications that will not
react well with your new medications. ASK YOUR
TRANSPLANT TEAM BEFORE YOU TAKE ANY OTC
MEDICATIONS.
20. Important Facts
• One of the leading causes of rejection is not taking
medications correctly.
• If you are unable to take your medications due to
nausea or vomiting CALL YOUR TRANSPLANT TEAM
IMMEDIATELY!
• Do not store your medications in your car.
• Do not cut or crush your medications unless you are
advised to do so.
• NEVER start or stop ANY medication without the
transplant team’s approval.
• YOU are responsible for taking your medications
correctly.
