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What Factors Affect Lung Transplant Survival?

By Jeany Miller
Updated May 17, 2024
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Lung transplantation surgery is often performed to replace a non-working lung or lungs, and patients who qualify for this procedure usually suffer from a severe lung disease. A number of risk factors may be involved with lung transplantation, some of which may directly affect lung transplant survival. Among these are the patient’s current health state, the presence of infection or complications after surgery, lung transplant rejection, postoperative care and compliance with doctor’s orders. The facility in which the lung transplant occurred as well as the genders of both the recipient and donor may also factor into the rate of survival.

Infection or other health complications that occur after a lung transplant may further influence one’s chances of survival. The lung may be susceptible to infection because of impaired mucus clearance and cough reflexes. A suppressed immune system to avoid lung transplant rejection may also contribute to the risk of infection. Fever, increased white blood cell count and positive sputum cultures may be early indicators of infection.

Additional health complications that may impact lung transplant survival include cardiovascular problems, coagulopathy and gastrointestinal problems. A change in blood flow or irregular heartbeat may occur following surgery but may be treatable with medications. Coagulopathy is a bleeding disorder in which the body’s blood does not clot properly. This can lead to excessive bleeding but may be treatable with blood platelets. Gastrointestinal complications may include nausea and vomiting, which may last up to six months after transplantation.

Lung transplant rejection often occurs at least once during the postoperative period, and usually within three months of the transplantation. This is known as acute rejection, and it indicates that the recipient’s body perceives the transplanted lung as an invader. Medication that suppresses the immune system may help with this, but chronic rejection may also ensue. Chronic rejection is normally characterized by a patient’s decreasing respiratory functions. In such an instance, the transplantation surgery may need to be re-performed.

Postoperative care is usually another factor in determining lung transplant survival. Patients, for example, often need to be positioned properly in their hospital beds to permit airway clearance and strong breathing patterns. Additional components of patient care may include early recognition of life-threatening complications, helping the patient return to normal activities as soon as possible and maintaining medications. Caring for the bronchial and tracheal openings from surgery is also important.

Once a patient leaves the hospital or care facility, following prescription medication orders and complying with a doctor’s instructions are often critical to survival. A patient’s physical capabilities may improve with physician-approved exercises and diet plans. Scheduling routine check-ups and eliminating dangerous habits like smoking may further impact the rate of lung transplant survival.

Some indicators also suggest that the facility in which the lung transplant occurs may relate to survival. Centers or hospitals that conduct large volumes of lung transplants may correlate to higher survival rates. Donor and recipient genders may also factor into lung transplant survival. Some health care professionals speculate that male-to-female lung transplants are not as successful as female-to-male surgeries.

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