University of Virginia Health System

Lung Transplantation

After the Transplant

During the hospital stay the transplant staff will work with the patient to prepare for discharge home. Once the patient goes home the staff in the lung transplant office will remain in contact for regular monitoring of lab work, medications and general well-being.

The patient will be scheduled for follow-up appointments to see a transplant pulmonologist and nurse coordinator. These visits will occur every 2 weeks for the first 10 weeks, then monthly for three months. Thereafter, visits to the transplant clinic will occur every three months.

Each clinic visit includes pulmonary function tests with discussion of results. The patient may occasionally need to have a chest x-ray or perhaps a bronchoscopy. Additional clinic visits will occur as necessary.

Labs

During the first 6 months after transplant patients have blood drawn by their lab once a week. As their anti-rejection medicines stabilize, transplant staff will decrease the frequency of lab work to twice monthly and eventually once a month.

Lung Transplant Rejection

A transplanted lung is considered foreign by the body's immune system. A class of anti-rejection drugs has been developed to protect the new organ. Unfortunately, they also have some undesirable side effects, especially increased risk of infection.

Symptoms of rejection include fever, cough, shortness of breath, and a decrease in exercise capacity. Unfortunately, these symptoms may also be seen with infections. For that reason, we usually require a lung biopsy to determine if the patient is experiencing a rejection or infection.

Despite the regular use of anti-rejection medications, patients may undergo several episodes of rejection (usually within the first three months of receiving the transplant). The likelihood of rejection declines after the first year. We anticipate that rejection will occur and it is not a complication related to surgery.

We understand that rejection episodes can be difficult, even frightening at times, for patients and their families. Patients should realize that acute rejection is a very treatable side effect of transplant.