Skip to Main Content




  • Single-lung transplant

  • Double-lung transplant

  • Living donor lobar transplant




  • V42.6 Lung replaced by transplant




  • Z94.2 Lung transplant status




  • 6C: Impaired Ventilation, Respiration/Gas Exchange, and Aerobic Capacity/Endurance Associated With Airway Clearance Dysfunction



A 16-year-old female is referred to a local outpatient physical therapy clinic 4 months after receiving a double-lung transplant due to cystic fibrosis (CF). She was receiving physical therapy three times a week at the hospital where she received the transplant. Her goal is to progress to swimming as her primary aerobic workout but has been working to progress her exercise tolerance and endurance using a treadmill and stationary bike. She also wants to increase her overall strength.




  • Diseased or defective lung (single-lung transplant) or lungs (double-lung transplant) or a portion thereof is removed

  • Healthy partial lung from a living donor or complete donor lung(s) from a deceased person is implanted

Essentials of Diagnosis

  • Most common causes in children under 1 year of age are congenital heart disease (CHD), peripheral vascular disease (PVD), and CF

  • Lung transplant considered when patient death is imminent within 1 to 2 years and all other medical options have been exhausted and/or are ineffective1

General Considerations

  • Timing of transplant for over 12 years of age depends on their lung allocation score (LAS)

  • Long-term outcomes are limited

  • Contraindications to lung transplant

    • Malignancy

    • Sepsis

    • Tuberculosis

    • Hepatitis

    • Neuromuscular disease


  • Forty-four lung transplants in 2011

  • Males more common than females

  • 0.02% pediatric lung transplants (<18 years old)

  • Double-lung transplants 5 to 6 times more common than single-lung transplants





  • Respiratory failure

  • Unable to tolerate exercise

  • Hypoxemia

  • Carbon dioxide retention

  • Failure to thrive

  • Abnormal pulmonary function tests (PFTs)

  • Syncope

  • Cyanosis

FIGURE 243-1

Number of patients awaiting lung transplants and number of lung transplants performed each year. Data derived from Scientific Registry of Transplant Recipients, 2002 (

Graphic Jump Location
FIGURE 243-2

Different types of tissue transplants (grafts). (From Chandrasoma P, Taylor CR. Concise Pathology 3rd ed. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
Possible Contributing Causes

  • Pediatric3

    • CHD

    • Surfactant dysfunction

    • Idiopathic pulmonary fibrosis (IPF)

    • Bronchiolitis obliterans (BO)

    • Pulmonary vascular disorder

    • Chronic lung disease of infancy

    • Pulmonary fibrosis/Idiopathic pulmonary fibrosis (IPF)

    • Pulmonary vein anomalies

    • CF

  • Adult

    • Pulmonary hypertension

    • Emphysema

    • CF

    • Alpha-1 antitrypsin deficiency1

    • IPF4

    • Interstitial lung disease...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.