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Lung Transplant for Lung Cancer: Is It an Option?

Medically reviewed by Leonora Valdez, M.D.
Written by Aminah Wali, Ph.D.
Posted on May 20, 2024

Some medical procedures are used only in certain cases. For people with severe lung damage, a lung transplant may be the best option for treatment. Although the procedure comes with risks, a lung transplant might help some people live a longer life.

People with various lung diseases can get lung transplants, but can you get one if you have lung cancer? In this article, we’ll cover the process of getting a lung transplant and when this treatment might be used for someone with lung cancer. Your health care provider can answer other questions you may have about lung transplants and who should get one.

What Is a Lung Transplant?

A lung transplant is a type of thoracic surgery (chest surgery) to replace failing, diseased lungs with new lungs from an organ donor. If just one lung is failing, that’s all that needs to be replaced — this is known as a single lung transplant. A double lung transplant, on the other hand, should be performed if both lungs no longer work.

For a lung transplant to work, the person receiving the transplant — also called the lung transplant recipient — and the donor have to be a match. A doctor considers several factors to determine if a recipient and a donor are a match, including:

  • Lung size
  • Blood type
  • Amount of oxygen the lungs can hold
  • Height
  • Age

A lung transplant recipient and donor who are similar in most of those areas may be considered a match. Other factors, like gender, aren’t always taken into account but may lead to better outcomes for some people, according to the European Journal of Cardio-Thoracic Surgery.

Who Can Get a Lung Transplant?

Although many people are living with lung disease, a lung transplant is only an option for some of them. Lung transplants are reserved for people with end-stage lung disease, whose lungs are so damaged from illness that they no longer work properly. People with end-stage lung disease usually have not responded to other treatments and may not live much longer without a transplant.

Even with advanced lung disease, a person’s overall health needs to be good enough for a lung transplant to be possible. Otherwise, the procedure may be too risky. Lung transplantation is not recommended for people who:

  • Have bacterial or viral infections
  • Are experiencing organ failure
  • Had a recent heart attack or stroke
  • Use cigarettes, marijuana, or other drugs
  • Are over age 70

Generally, lung transplants are not recommended for people with cancer in any part of the body. However, the procedure may sometimes be an option. Doctors determine who might be eligible for a lung transplant on a case-by-case basis.

Diseases That Can Lead to a Lung Transplant

Many diseases can cause severe damage to the lungs over time. Lung transplants are most often performed for people with medical conditions such as:

  • Pulmonary fibrosis (scarring and inflammation of the lungs)
  • Chronic obstructive pulmonary disease (COPD) — Prevents proper airflow through the lungs
  • Emphysema — Causes breathing problems and often occurs alongside COPD
  • Cystic fibrosis — Leads mucus to build up in the lungs
  • Pulmonary hypertension (high blood pressure in the lungs’ blood vessels)

A lung transplant isn’t typically recommended to treat lung cancer but may be an option in some cases. Additionally, COPD can increase the risk of lung cancer. If you have both lung cancer and COPD, your doctor may discuss the possibility of a lung transplant.

Lung Transplantation for Lung Cancer

It’s uncommon to treat lung cancer with a lung transplant — only about 0.1 percent of lung transplants are done in people with lung cancer. Additionally, lung transplantation is recommended only for certain forms of lung cancer, based on how the cancer cells look under a microscope. If the usual medical treatments haven’t worked, lung transplantation may be considered for these types of lung cancer:

  • Minimally invasive carcinoma
  • Adenocarcinoma in situ
  • Invasive mucinous carcinoma
  • Diffuse lung cancers, which may be difficult to remove using surgery and often don’t respond well to other treatments

A lung transplant typically isn’t recommended once metastasis (spread of cancer) has occurred. However, an ongoing clinical study aims to show that a double lung transplant may extend the life of people with late-stage lung cancer.

The procedure may be an option for some people, but can a lung transplant cure lung cancer? Even though cancer clinical studies found cancer recurred in 40 percent to 50 percent of double lung transplants, researchers report that the procedure can be a successful treatment for many people with certain types of lung cancer.

The Process of Getting a Lung Transplant

If your doctor determines that you’re a good candidate for a lung transplant, you’ll go on a waitlist to be matched with a suitable donor. This may take two or three years, and not everyone finds a match. Although about 4,000 transplant candidates get on a waitlist each year, only about 2,500 receive lung transplants.

Once a suitable donor is found, your lung transplant can be scheduled. You may need to travel to another city or state for the procedure. An experienced surgeon will need to perform surgery to remove your lungs and transplant the donor lungs.

Immediately after the procedure, you’ll be transferred to the hospital’s intensive care unit to recover. You’ll also need to plan on several follow-up visits with your health care provider so that they can monitor you for signs of any problems.

Side Effects of a Lung Transplant

Lung transplantation can be a lifesaving surgery, but it also comes with major risks. Like any major surgery, there’s a chance of complications that could cause long-term damage or even death. Potential complications include:

  • Blood clots
  • Scarring
  • Reactions to anesthesia (pain medication used during surgery)
  • Infections
  • Fluid buildup in the lungs
  • Rejection of the new lung

Cancer is another possible complication of a lung transplant. Compared with the general population, people who undergo a lung transplant are five times more likely to develop lung cancer after a lung transplant.

Even though organ transplantation can happen only when the recipient and donor are a match, your body can still recognize that the new organ isn’t your original one. This can cause your immune system to attack, or reject, the new organ. To decrease the likelihood of rejection, transplant recipients take drugs called immunosuppressants, which weaken the immune system.

Immunosuppression is important for a transplant to be successful, but it can cause unwanted side effects. Immunosuppression also rarely lasts forever. Many transplant recipients will eventually experience rejection of the transplanted lung, even years after surgery.

Common Treatments for Lung Cancer

Since lung transplantation isn’t commonly used for people with lung cancer, you’ll likely need a different treatment option.

If you have early-stage disease, you might only need surgery to remove the lung tumor, sometimes followed by chemotherapy. If surgery isn’t enough or you have advanced lung cancer, you might receive other cancer treatments such as:

  • Radiation therapy, which uses high-energy X-rays to shrink tumors
  • Chemotherapy drugs that can kill quickly dividing cells, like cancer cells
  • Targeted therapies, which precisely attack one type of protein

The best lung cancer treatment for you depends on the particular type of lung cancer you have and your overall health. Your doctor can go over your options with you and help figure out a treatment plan that will give you the best chance at a better quality of life.

Talk With Others Who Understand

MyLungCancerTeam is the social support network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Do you have more questions about lung transplants as a treatment option for lung cancer? Share your insights in the comments below, or start a conversation by posting on your Activities page.

Posted on May 20, 2024
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Leonora Valdez, M.D. received her medical degree from the Autonomous University of Guadalajara before pursuing a fellowship in internal medicine and subsequently in medical oncology at the National Cancer Institute. Learn more about her here.
Aminah Wali, Ph.D. received her doctorate in genetics and molecular biology from the University of North Carolina at Chapel Hill. Learn more about her here.

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