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What can I expect immediately after my lung transplant?

Immediately after surgery, lung transplant patients recover for two to four days in the Cardiothoracic Intensive Care Unit. Patients will likely require the assistance of a ventilator for a day, and will receive pain medications, immunosuppressant medications, antibiotics, and other medications per the Lung Transplant Program's protocol. Patients are transferred to the transplant unit when they are ready, where daily physical and pulmonary therapy will begin. Recent advancements in anesthesia, surgical techniques, and post-operative care have dramatically shortened the time patients spend in the hospital to approximately 14 days.
Lung transplant patients at Columbia University Medical Center spend the first two to four post-surgical days in the center's sophisticated cardiothoracic intensive care unit (CTICU). From there, lung transplant patients recuperate in a state-of-the-art transplant unit.

Most likely you will be placed on a ventilator but will probably be taken off it within 24 hours post-surgery. Your postoperative pain will be managed by your transplant team in collaboration with the critical care anesthesiologist/pain management specialist.

You will begin your many (often between 8 and 10) medications immediately following the surgery. Among them will be three immunosuppressants. Because your body is designed to identify "foreign invaders" and to reject them, these anti-rejection medications are mandatory for suppressing the body's natural immune response to the new lung(s). Unfortunately, the risk of rejection never goes away. For that reason, you will be taking immunosuppressants for the rest of your life.

In addition, you will begin taking antibacterial, antifungal, and antiviral medications, which will be altered according to your culture results and clinical course. Vitamin and mineral supplements (e.g., calcium, magnesium, iron) will be prescribed to ensure your recovery from the transplant surgery.

Lying in bed too long can drain your energy. As soon as you are transferred to the transplant unit, you will begin receiving physical and pulmonary therapy every day.

While you are in the hospital, new transplant coordinators will begin overseeing your post-transplant follow-up care. They will answer any questions you may have and review your medications as well as discuss possible side effects and drug interactions, and prepare you for necessary lifestyle changes and follow-up regimens. In general, they continue to educate you and your family on the often complex post-transplantation process.
People awaken from lung transplant surgery in the intensive care unit (ICU). They see many tubes attached to them and medical apparatus around the bed.

A breathing tube in the mouth and into the airway is connected to a ventilator. This assists people with breathing during surgery and while waking up until they are able to do the work of breathing on their own. They are unable to talk while the tube is in place. Typically, the breathing tube is removed when recipients are fully awake from the anesthesia, which can take from two to three days after the surgery.

Soft restraints are placed on the wrists to keep recipients from accidentally pulling on the tubes as they wake up. The restraints are removed once people are awake and able to follow instructions.

Recipients receive several medications to support their new lung in the first few days following transplant. These medications are delivered through an intravenous (IV) line and will slowly be changed to pill form over the next several days.

Catheters (tubes) are placed in the neck, arms and wrist to assist with monitoring pressure and blood flow through the heart, lungs and rest of the body. All of the tubes and catheters are removed as recipients recover.

Two chest tubes are placed in each transplanted lung. So, a single lung transplant patient has two tubes, and a bilateral (double) lung transplant patient has four chest tubes. These tubes are placed during surgery and are intended to drain air and fluid from the area around the new lung(s) inside the chest, allowing the lung(s) to fully expand.

A bladder catheter is in place to drain urine. Early post-operatively, urine output is closely monitored to make sure that kidney function is intact. Once a person is able to move independently, this tube is removed.

People who spend more than a couple of hours a day in bed are at risk to develop blood clots in their legs. To prevent this, compression boots are applied to the lower legs. These devices gently inflate and deflate (like a blood pressure cuff) to promote good blood movement.

As soon as people are able to participate in physical therapy, the pulmonary rehabilitation team begins to work with them. Typically, this work begins in the ICU and continues throughout the hospitalization and beyond.

Most people are in the intensive care unit for three to five days. A decision to advance a patient to the lung transplant floor is based on the individual's condition.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.