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Risks - Lung transplant

A lung transplant is a complex operation and the risk of complications is high.

Some complications are related to the operation itself. Others are a result of the immunosuppressive medicine, which is needed to prevent your body rejecting the new lungs.

Reimplantation response

Reimplantation response is a common complication affecting almost all people with a lung transplant.

The effects of surgery and the interruption to the blood supply cause the lungs to fill with fluid.

Symptoms include:

The symptoms are usually at their worst 5 days after the transplant.

These problems will gradually improve, and most people are free of symptoms by 10 days after their transplant.

Rejection

Rejection is a normal reaction of the body. When a new organ is transplanted, your body's immune system treats it as a threat and produces antibodies against it, which can stop it working properly. 

Some people experience rejection, usually during the first 3 to 6 months after the transplant.

Shortness of breath, extreme tiredness (fatigue) and a dry cough are all symptoms of rejection, although mild cases may not always cause symptoms.

Acute rejection usually responds well to treatment with steroid medicine.

Bronchiolitis obliterans syndrome

Bronchiolitis obliterans syndrome (BOS) is another form of rejection that typically occurs in the first year after the transplant, but could occur up to a decade later.

In BOS, the immune system causes the airways inside the lungs to become inflamed, which blocks the flow of oxygen through the lungs.

Symptoms include:

  • shortness of breath
  • a dry cough
  • wheezing

BOS may be treated with immunosuppressant medicine.

Post-transplantation lymphoproliferative disorder

After having a lung transplant, your risk of developing a lymphoma (usually a non-Hodgkin lymphoma) is increased, although the chance of getting it is rare. Lymphoma is a type of cancer that affects white blood cells.

This is known as post-transplantation lymphoproliferative disorder (PTLD).

PTLD occurs when a viral infection (usually the Epstein-Barr virus) develops as a result of the immunosuppressants that are used to stop your body rejecting the new organ.

It can usually be treated by reducing or withdrawing immunosuppressant therapy.

Lymphoma Action has more information about lymphoma.

Infection

The risk of infection for people who have received a lung transplant is higher than average for a number of reasons.

Common infections after a transplant include:

Long-term use of immunosuppressants

Taking immunosuppressant medicine is necessary following any type of transplant, although they do increase your risk of developing other health conditions including:

Cancer

People who have received a lung transplant have an increased risk of developing cancer at a later date.

This would usually be 1 of the following:

Because of this increased risk, regular check-ups for these sorts of cancers may be recommended.

Page last reviewed: 21 December 2022
Next review due: 21 December 2025