When CF lung disease advances to end-stage respiratory failure that no longer responds to medicines and airway clearance, a bilateral (double) lung transplant can extend and improve life. Both lungs are replaced because CF lungs are chronically infected. It does not cure CF elsewhere in the body (the pancreas, sinuses, and GI tract are still affected), and it requires lifelong immune-suppressing medicines. Candidates are evaluated carefully by a transplant center; the widespread use of CFTR modulators has changed and, for many, delayed the need for transplant.
Performed at a specialized transplant center under general anesthesia, often with cardiopulmonary bypass. Both diseased lungs are removed and donor lungs are implanted and connected to the airway and blood vessels. It follows a rigorous evaluation and time on the transplant waiting list.
An intensive-care and hospital stay followed by pulmonary rehabilitation over months. Lifelong immunosuppression, frequent monitoring, and surveillance for rejection and infection are required. Many recipients regain substantial lung function and quality of life; outcomes depend on the center and individual factors.