Transplant Services


Lung Transplant

Lung transplantation can prolong and dramatically improve the quality of life for patients with advanced lung disease. The Center for Advanced Lung Disease and Lung Transplantation at NewYork-Presbyterian/Columbia University Irving Medical Center is one of the oldest in the United States, with decades of lung transplantation experience and expertise. 

Our lung transplant doctors and surgeons have performed more than 1,500 lung and heart-lung transplants since 1988. Our lung transplant survival rates have remained the same and even higher at later 3 and 5 year time points than the national average even though we treat sicker patients than most lung transplant centers nationwide. Over the years, we have earned a reputation for our clinical expertise and rigorous commitment to excellence working to expand the pool of donor lungs and bridging critically ill patients with respiratory failure to lung transplant through innovative technologies.

What is a Lung Transplant?

What is a Lung Transplant?

A lung transplant is a procedure to surgically replace a patient’s diseased lung(s) with healthy donated lung(s) from another individual. A lung transplant is performed in patients who cannot be successfully treated using medications, have previously undergone other treatment methods without success, and have a short life expectancy without a lung transplant.

What Conditions are Treated by a Lung Transplant?

Conditions Treated

A lung transplant is required when the lungs can no longer support the pulmonary needs of the body. The conditions that require a lung transplant may include:

Repairing and reconditioning donated lungs 

Because so many donor lungs are damaged at the time of death, approximately 20-25 percent are viable for transplantation. NewYork-Presbyterian/Columbia doctors participated in a pivotal clinical trial showing the effectiveness of a novel technique called “ex vivo lung perfusion” (EVLP). By evaluating and preparing donor lungs outside the body before transplant surgery, EVLP could significantly increase the available pool of donated lungs by reconditioning donor lungs that have sustained damage making them suitable for transplantation. 

The lungs are warmed to normal body temperature, flushed of donor blood, inflammatory cells, and potentially harmful biologic factors, and treated with antibiotics and anti-inflammatory agents. In some cases, lungs that might have previously been deemed unsatisfactory for transplantation can be successfully replenished and repaired with EVLP, rendering them usable. The first ex vivo lung transplantation at NewYork-Presbyterian/Columbia was performed in 2011, saving the life of a 59-year- old woman.

How is a Lung Transplant Performed?


A lung transplant is a major procedure that can take 6 to 8 hours to perform and requires a stay in the hospital. 

The lung transplant procedure involves the following steps:

  1. General anesthesia is administered through a breathing tube that is placed down the patients throat to ventilate the lungs so the patient can breathe and doesn’t feel any pain
  2. A lung transplant surgeon makes an incision in the chest 
  3. A cardiopulmonary bypass or ECMO machine may be used, if needed, to keep blood circulating during the operation
  4. The chest is opened, and the transplant team connects the main airway and blood vessels between the lung and heart to new lung(s)
  5. The diseased or damaged lung or lungs are removed. If a heart-lung transplant surgery is being performed, the transplant team will remove the heart and lungs.
  6. The new donor lung or lungs are sewn in place
  7. The transplant team will close the chest and the bypass machine removed when the new lung or lungs are working on its own
  8. The tubes will be left in the chest for several days to drain any excess fluid while the patient is in the intensive care unit (ICU)
  9. Once the patient is breathing and the lungs are performing on their own, tubes are removed, and the patient is moved to a hospital room in the transplant unit

Risks to Consider

Risks to Consider

A lung transplant is considered a major surgery that could cause side effects or complications. The risks associated with a lung transplant vary depending on the overall health of the patient and include:

  • Bleeding
  • Blood clots
  • Blockage of the blood vessels or airways going to the new lung(s)
  • Infection
  • Medication side effects
  • Pulmonary edema or fluid in the lung(s)
  • Rejection or infection of the new lung(s) 

Lung transplant surgery can be complicated especially if the body starts to reject the new organ. If the immune system sees the new organ as a threat it will start to attack it. To combat the possibility of the body rejecting the new organ, anti-rejection medications are prescribed which can cause many side effects including:

  • High blood pressure and cholesterol
  • Chronic kidney disease
  • Hair growth or loss
  • Stomach issues
  • Weight gain 

Anti-rejection medications can also aggravate existing conditions or increase the possibility of developing new ones such as cancer, diabetes, high blood pressure, kidney damage, or osteoporosis. All of these risks and potential complications that should be discussed with your doctor.

Preparing for a Lung Transplant

Preparing for a Lung Transplant

Preparing for a lung transplant is lengthy and typically begins months, potentially longer when factoring in the wait list time, before surgery. The process starts with a complete medical history and physical examination by the transplant team including:

  • Blood tests. Blood tests are required to help match the patient with a donor.
  • Diagnostic tests. Multiple diagnostic tests will be performed to determine the overall health of the patient such as X-rays, CT scans, ultrasound, pulmonary function tests, lung biopsy, and a dental exam. Women may also go through gynecology testing and evaluations.
  • Psychological and social evaluations. A patients psychological and social environment can have a major impact on the outcome of a lung transplant. Patients are evaluated for stress and anxiety, their health insurance with medication coverage, and their support from family and friends. 

Other criteria and requirements that must be met prior to a lung transplant:

  • Immunizations. A list of several immunizations will be provided and given to decrease the chance of infection.
  • Non-smoker. Patients approved for a lung transplant must be nicotine-free for several months to qualify for the transplant waiting list.
  • No active drug or alcohol use for several months

What to Expect After a Lung Transplant

After the Transplant
Intensive care and hospital stay
  • Intensive care unit (ICU). Most patients should expect to stay in the intensive care unit for one to two days. A ventilator will help with breathing and tubes will be present in the chest to drain excess fluids from around the heart and lungs. Strong medications will be administered to prevent rejection of the new lung(s), infection and for pain. As the patient progresses, the ventilator is removed and the patient is moved to a hospital room in a dedicated transplant unit.
  • Hospital. The average time for most patients to stay in the hospital after leaving the ICU is 14 days. This can vary depending on the overall health and progress of the patient after surgery. 
At-home recovery
  • Your doctor will provide specific at-home instructions to help prevent infection and rejection.
  • Monitoring of medications and side effects to avoid organ rejection and infection. Signs of rejection can include shortness of breath, congestion, coughing, or fever. Antibiotics, antiviral, or other antifungal medications may also be prescribed.
  • Frequent follow-up appointments with your transplant team and doctor for the first three months will be required to monitor your progress and lung function. 
  • Various tests will be required during follow-up appointments to monitor progress. Tests include blood work, X-rays, lung functions tests, lung biopsy, an electrocardiogram (ECG), and other laboratory tests.
  • The recovery process for a lung transplant can take up to three to six months depending on the overall health of the patient. 
Lifelong and follow-up support 
  • Exceptional survival rates. The survival rates for our lung transplant recipients have soared for above the national average. Since the inception of new leadership in 2001, we have performed more than 1,300 operations with the one-year patient survival of about 90 percent and three-year patient survival around 80 percent, which is statistically better than expected for three-year graft survival. The average waiting time for a lung transplant is 6-7 months, with one in four patients receiving a transplant within ten weeks of being placed on the Lung Transplant Wait List.
  • Lifelong follow-up and support. Transplantation is a life-altering procedure. Patients need life-long immunosuppressant medications and very careful monitoring indefinitely. Throughout the transplant process and beyond, we partner closely with recipients and referring physicians to achieve a seamless continuum of care, while helping patients and their families navigate any emotional, financial, and logistical concerns they may have. Our transplant team is here for the patients – for life.
Get Care

Receive a Lung Transplant at NewYork-Presbyterian

Patients travel across the country and across the globe to receive care from the lung transplant team of experts at NewYork-Presbyterian. As one of the top lung transplant programs in North America, we treat some of the most complex cases that other transplant centers are not equipped for, yet our patient survival rates are at or above the national average. 

If you or a family member are in need of a lung transplant or other organ transplants, call to schedule an appointment with one of our NewYork-Presbyterian transplant doctors to learn more about what specific treatment options are available to you.