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If a lung transplant is thought to be an option for you, you'll be referred for a transplant assessment.

There are a number of specialist centres that carry out lung transplants in England.

They are:

• Freeman Hospital, Newcastle
• Harefield Hospital, London
• Papworth Hospital, Cambridge
• Queen Elizabeth Hospital, Birmingham
• Wythenshawe Hospital, Manchester

A small number of children's lung transplants are carried out at Great Ormond Street Hospital and Freeman Hospital.

Tests will be carried out to make sure your other major organs, such as your heart, kidneys and liver, will function properly after the transplant.

These may include blood tests and any of the following investigations:

• a chest X-ray
• an echocardiogram to check how well your heart is pumping
• an electrocardiogram (ECG), which records your heart's electrical activity
• an angiogram, a type of X-ray that can be used to check the blood flow in the blood vessels of your lungs

After the assessment is complete, a decision will be made as to whether a lung transplant is suitable for you and whether it's the best option.

It may be decided that:

• you should go on the active waiting list – which means you could be called for a transplant at any time
• a transplant is suitable for you, but your condition is not severe enough – you'll be reviewed regularly and if your condition worsens, you'll be put on the active waiting list
• you need more investigations or treatment before a decision can be made
• a transplant is not suitable for you – the assessment team will explain why and offer alternatives, such as medicine or other surgery
• you need a second opinion from a different transplant centre

The supply of donor lungs is limited, which means there are more people who'd benefit from a lung transplant than there are donor lungs.

This means people who are unlikely to have a successful transplant are not usually considered suitable for transplant.

You may also be considered unsuitable if:

• you have not given up smoking
• your other organs, such as your liver, heart or kidneys, do not function well and may fail after the stresses of the transplant operation
• your lung disease is too advanced, so it's thought you'd be too weak to survive surgery
• you have a recent history of cancer – there's a chance that the cancer could spread into the donated lungs; exceptions can be made for some types of skin cancer as these are unlikely to spread
• you have another condition or infection that would make the transplant too dangerous
• you're significantly underweight with a body mass index (BMI) of less than 17, or very overweight (obese) with a BMI of 30 or above
• you have a serious mental health condition that has been difficult to treat
• you have an alcohol or drug addiction and have been using in the past 6 months

Age also plays a part because of the effect it has on likely survival rates.

There are no set rules and exceptions can sometimes be made.

The length of time you'll have to wait may depend on your blood group, donor availability and how many other people are on the list and how urgent their cases are.

While you wait, you'll be cared for by the doctor who referred you to the transplant centre.

They'll keep the transplant team updated with changes to your condition.

Another assessment is sometimes necessary to make sure you're still suitable for a transplant.

Your transplant team will often be given short notice of donor organs, so will have to move swiftly.

When a suitable donor is found, you'll usually need to be in hospital ready for your transplant within 6 to 8 hours.

When a suitable donor lung is found, the transplant centre will contact you and ask you to go to the centre.

When you hear from the transplant centre:

• do not eat or drink anything
• take all current medicines with you
• take a bag of clothes and essentials for your stay in hospital

At the transplant centre, you'll be quickly reassessed to make sure no new medical conditions have developed.

At the same time, a second medical team will examine the donor lungs.

The lung transplant must be carried out as quickly as possible to ensure it has the best possible chance of being successful.