What to Expect After Surgery

Waking up after transplant surgery can feel overwhelming. You’ll be in the intensive care unit, and you may see lots of tubes, machines and monitors. This is all normal and helps your medical team take good care of you.

You’ll be under general anesthesia during surgery. When you wake up:

  • You may still be on a ventilator (a machine that helps you breathe).
  • You’ll have several tubes and wires to monitor your body and remove fluids.
  • You’ll likely have restraints on your wrists to keep you from pulling out any tubes by accident.
  • Nurses and doctors will be checking on you often.

You might feel pain, confusion or have strange dreams at first. These symptoms usually go away as your body heals and the medications wear off.

Equipment you may have

  • Breathing tube: Helps you breathe while your lungs adjust.
  • Nasal/gastric tube: Keeps your stomach empty until you can eat again.
  • Chest tubes: Drain fluid from around your lungs.
  • Foley catheter: Tracks how much urine your body makes.
  • IV lines: For giving medicine and taking blood samples.
  • ECMO: Extracorporeal membrane oxygenator (LINK PENDING)

Recovery in the hospital

Your team will check your temperature, oxygen levels, blood pressure, radiographs, and many blood tests You’ll also get chest physiotherapy to keep your lungs clear and prevent infection. This may include:

  • Breathing exercises.
  • Using an incentive spirometer (handheld breathing tool).
  • Gentle chest tapping.
  • Coughing exercises.
  • Inhaled medications.

From a physical therapy viewpoint, the goal is to help you get out of bed and even walking as soon as you are able. As you get stronger, tubes and monitors will be removed, and you’ll move from the ICU to the transplant unit. Everyone heals at different rates and recovery times vary from a week to several weeks.

Returning home: 1 day to 6 months after transplant

As you prepare to leave the hospital, your transplant team will teach you:

  1. How and when to take your medicines.
  2. How to care for your incision.
  3. Discuss the details of the recovery process.
  4. Discuss issues of everyday life and your new daily routine.
  5. Schedule follow-up appointments.

Your body will still be healing, so it’s important to be careful with physical activity and give yourself time to rest. It’s completely normal to have both good days and tough ones — try to be patient with yourself and focus your energy on getting stronger, one day at a time.

Things to do and avoid after transplant

What to do:

  • Monitor your temperature, weight, blood pressure and lung volume as directed by your care team
  • Slowly increase activity as tolerated.

What to avoid:

  • Driving or operating heavy machinery: your team will let you know when it is safe
  • Lifting heavy objects : your team will let you know what is allowable and when you can increase the weight.
  • Staying away from crowds and wearing a mask is important after transplantation.

Living well as a transplant recipient

Lung transplantation involves a complete lifestyle change, and while patients no longer require pulmonary hypertension medications, they now require a new set of medications that allows their body to accept the lungs as well as prevents infections. Careful medical follow-up is crucial to Staying healthy after a transplant takes effort. You’ll be on immunosuppressants for life, which make infections easier to catch. Here are some everyday precautions to help protect your health, reduce infection risk and support your long-term success.

To avoid germs and infections at home:

  • Do not change diapers or clean cat litter boxes, bird cages or pet ears.
  • Avoid changing vacuum bags, furnace filters or working in dusty areas.
  • Don’t handle mulch or compost. Wear a mask and gloves if gardening.
  • Wash your hands often, especially before eating or touching your face.
  • Avoid eating or drinking from shared containers or utensils.
  • Wash dishes with very hot water or use your dishwasher’s the highest setting.
  • Ask your doctor before getting a new pet.
  • Make sure your pets see a vet regularly and are up to date on all shots.
  • Vacuum your mattress once a month.
  • Avoid strong chemical fumes.

Children living in your home should not receive live virus vaccines.

  • Avoid anyone who is sick.
  • Wear a mask outside on windy or dusty days.
  • Stay away from construction or demolition sites.
  • Do not swim in lakes, ponds or other still water.
  • Always wear shoes outdoors.
  • Use sunscreen with SPF 45 or higher when outside.

  • Clean and bandage cuts right away.
  • Tell your transplant team if you have pain, swelling, redness or pus from a wound.
  • See your dentist every six months.
  • Let your team know if you notice sores or white patches in your mouth.
  • You can wear nail polish, but do not wear false nails or tips, as they increase infection risk.
  • Ask your doctor before any dental work or surgery. You may need special medications.
  • Everyone in your household should get a flu shot each year.

Some transplant medications increase the risk of cancer. Take these steps to stay safe:

  • Always wear SPF 45 or higher when going outside.
  • Women should do monthly breast self-checks.
  • Keep up with Pap smears and mammograms as recommended by your doctor.

Eating well helps you manage side effects of transplant medications, such as weight gain, high blood sugar and swelling.

Follow these tips:

  • Choose low-sodium foods.
  • Limit saturated fats and cholesterol.
  • Cut back on sugary snacks and drinks.
  • Reach and maintain a healthy weight.
  • Limit alcohol intake to one drink and only on special occasions.
  • To prevent infection, avoid raw seafood and rare meats.
  • Also to prevent infection, avoid fresh salads at restaurants.

Check with your doctor before resuming sexual activity. You may need to avoid pressure on your chest or incision.

Important reminders:

  • Use condoms – even in long-term relationships. Minor infections (like yeast infections) could be dangerous when you’re immunosuppressed.
  • Prevent pregnancy – For women, pregnancy may be risky after a lung transplant. Use condoms or an added form of birth control.

Medical Alert Bracelet

If you had a Medical Alert Bracelet for PH, get a new one that says you’re a lung transplant recipient. It should include:

  • Your name.
  • “Lung transplant recipient”
  • “Immunosuppressed”
  • Transplant center or doctor’s phone number.

When to contact your transplant coordinator

Call your coordinator right away if you experience:

  • Temperature over 100 F.
  • Productive cough.
  • Shortness of breath.
  • Flu-like symptoms or chills.
  • Sores, rashes, blisters or lumps.
  • Redness or pus from a cut or wound.
  • Nausea, vomiting or diarrhea that lasts more than 24 hours.
  • Increase in fatigue.
  • Burning on urination.
  • Decrease in FEV1 or FVC by 10% in one day, or a downward trend over three days or more.
  • Weight gain of more than 3 pounds in one day.

You should also feel comfortable calling anytime you have questions or concerns.

Complications and emotional adjustments

  • Medications and Transplant Rejection

    Your immune system may think of your new lung(s) as a foreign object, so you’ll take immunosuppressants to keep your immune system from fighting your transplanted lungs. Here are common side effects and rejection symptoms to watch for.