Chronic obstructive pulmonary disease (COPD) is a condition that develops when there is damage to the lungs. A lung transplant is a surgical option for people with advanced stages of COPD.

COPD is an umbrella term for chronic lung conditions, such as emphysema and chronic bronchitis, that cause limitations in lung airflow and result in difficulty breathing. Evidence suggests that 16 million people in the United States have COPD and that many more may be living with it but have not received a diagnosis.

Research indicates that COPD is the third leading cause of death worldwide. People can take preventive steps, such as quitting smoking and avoiding lung irritants, to reduce the likelihood of developing COPD, but the condition is not curable once it develops. While there is currently no cure, treatments are available.

Treatment options for people with more advanced cases of COPD include:

Typically, lung transplants are the final treatment option for people with severe COPD.

In this article, we discuss lung transplants and COPD, including whom the surgery is for, as well as the benefits and risks of the surgery.

An imaging scan on the lungs.Share on Pinterest
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Currently, there is no cure for COPD. However, available treatments can help a person breathe with greater ease, stay more active, and slow the progression of the condition.

In particular, research suggests that lung transplantation often improves quality of life for people with severe COPD.

Researchers are still investigating the benefits and risks of lung transplants for people with COPD.

The two main benefits a lung transplant aims to achieve are an increase in life expectancy and a higher quality of life for people with end stage COPD.

However, while survival rates following lung transplants are improving, they generally fall behind the rates of other solid organ transplants.

Although lung transplants can improve lung function, they also have many risks, such as infections and rejection of the transplanted lung.

Typically, the waiting list for surgery is very long too. Therefore, it is advisable for an eligible person considering a lung transplant to discuss the benefits and risks with a doctor.

According to the International Society for Heart and Lung Transplant, a person must meet the following criteria to receive a lung transplant:

  • the condition is worsening despite treatment
  • the person enters a hypercapnic state, which refers to having too much carbon dioxide in the blood, which can cause long-term complications
  • they enter a hypoxemic state, which refers to having too little oxygen in the blood, which can result in a number of health problems
  • their forced expiratory volume in 1 second — which is the amount of air a person can force out of their lungs in 1 second — is less than 25% lower than the value the doctor predicts they would have if the lungs were working normally

Additionally, a doctor may consider placing a person on the lung transplant waiting list if they have:

  • a BODE index score of at least 80%, which is a scoring system that predicts a person’s risk of dying from respiratory conditions
  • three or more severe COPD exacerbations in the past year
  • moderate to severe pulmonary hypertension

Lung transplants are available for people with end stage COPD.

A doctor will only carry out the surgery if there is no other option and if the possible benefits of the procedure outweigh the potential risks.

Lung transplants are an effective way of increasing short-term survival in people with COPD, with 91–92% of people who receive successful transplants surviving for at least 3 months after the surgery.

However, research is yet to determine whether lung transplants for people with COPD have long-term benefits for life expectancy.

Older research indicates that lung transplants are the only intervention that can substantially improve long-term outcomes in people with very advanced cases of COPD.

This is consistent with other sources indicating that survival benefit and life expectancy improve following surgery in those with more severe COPD.

While many factors — among them a person’s general health and the success of the surgery — play a key role, evidence shows that most people survive the procedure and that roughly half of those receiving a lung transplant survive for at least 5 years.

There are three types of lung transplant:

  • Single lung transplant: This operation involves a person receiving one lung.
  • Double lung transplant: During this procedure, sometimes called a bilateral lung transplant, a person receives two lungs.
  • Combined heart and lung transplant: In this procedure, a person receives a heart and two lungs. This is generally only for people with either a congenital condition or a lung disease that has significantly damaged the heart.

A single lung transplant carries a greater risk of a person developing complications such as acute native lung hyperinflation and lung cancer in the remaining lung. Research suggests that, as a result, life expectancy is significantly higher for those who undergo double rather than single lung transplant.

However, a doctor may consider a single lung transplant, because not everyone is a suitable candidate for a double lung transplant and because there are more single lungs available.

Surgeries such as lung transplants are usually a last resort for people who have severe COPD symptoms that do not improve after other treatments.

Other treatments for COPD may include:

  • Lifestyle changes: Typically, this involves stopping smoking and avoiding other potential irritants.
  • Medications: This usually includes bronchodilators.
  • Vaccines: A doctor may suggest vaccines such as the flu and pneumococcal vaccines, as the flu and pneumonia can cause serious complications in people with COPD.
  • Pulmonary rehabilitation: This is a broad program aiming to help improve the well-being of people with COPD. It may involve exercise programs, nutritional plans, and a disease management training.
  • Oxygen therapy: This treatment increases levels of oxygen in a person’s blood. A person may receive oxygen therapy from tubes resting in their nose, from a face mask, or from a tube placed in the trachea, also known as windpipe.
  • Other surgeries: Besides lung transplantation, other surgical options include a bullectomy and lung volume reduction surgery. Both involve removing damaged tissue from the lungs.

Learn about home remedies for COPD here.

COPD is a long-term condition that limits the function of the lungs and causes difficulty breathing. Severe cases are life threatening and a leading cause of mortality. There is currently no cure, but treatments are available.

Lung transplant surgery is one of the final options for a person with very severe COPD. The procedure may improve a person’s quality of life, but it also comes with numerous risks.

While scientists are still researching the benefits of this surgery, evidence suggests that lung transplants are generally beneficial for a person with end stage COPD.

A person should discuss the benefits and risks of a lung transplant with a doctor.