When you live with advanced lung disease, the idea of a lung transplant can feel like a lifeline. But it may also be confusing, emotional, and overwhelming, especially when it comes to understanding how the lung transplant waiting list works.
Here’s what you need to know about the process, including lung transplant criteria and how to stay healthy and manage stress while you wait.
How to Get on the Lung Transplant Waiting List
Getting on the lung transplant waiting list begins with a referral, an evaluation, and a review of your health, lifestyle, and support system. These steps help your transplant team decide whether a transplant is the safest and most effective option for you.
Referral and intake
Your doctor can refer you to a transplant center — or you can refer yourself. After receiving your referral, an intake coordinator will reach out to gather basic information to better understand your medical needs. They’ll also review your insurance and schedule your evaluation.
Evaluation process
Your evaluation includes several days of scheduling testing and consultations with a multidisciplinary team. You’ll meet with pulmonologists, surgeons, social workers, dietitians, financial coordinators, and transplant nurses. They’ll review your medical history, talk with you about your goals, and assess if you’re ready for a transplant.
You’ll also complete a series of tests, which may include:
- Bloodwork.
- Cancer screenings.
- Compatibility testing (blood type, tissue typing, cross‑matching).
- Heart testing.
- Imaging.
- Pulmonary function tests.
These tests help your team understand your overall health and determine whether you can safely have transplant surgery.
Your team will also evaluate how quickly your disease is progressing and whether treatments are still effective. You may qualify for a lung transplant if you have a life‑threatening lung disease that no longer responds to treatment. This includes severe lung diseases and conditions like:
- Chronic obstructive pulmonary disease (COPD).
- Cystic fibrosis.
- Pulmonary fibrosis.
- Pulmonary hypertension.
Lung transplant criteria
Meeting medical criteria is only part of the picture. Transplant care is complex. The American Society of Transplantation emphasizes that consistent follow‑through is essential for long‑term success.
Transplant centers also look at your lifestyle and your ability to manage the lifelong care that follows a lung transplant. You must:
- Be able to follow medical instructions — You must take medications exactly as prescribed, attend frequent appointments, complete testing, and communicate changes in your health.
- Be cancer-free for at least five years — If you have a history of cancer, your risk of it recurring increases after a transplant. A five‑year cancer‑free period helps ensure your body is stable enough for surgery and immunosuppressive medications.
- Be emotionally and mentally prepared — Transplant is a lifelong commitment. You may meet with social workers or psychologists to assess stress, anxiety, depression, or other concerns.
- Be free of active infections — Infections can temporarily make you ineligible because immunosuppressive medications weaken your immune system after a transplant.
- Be nicotine-free for at least six months — This includes cigarettes, vaping, cigars, chewing tobacco, nicotine patches, and nicotine gum. Nicotine affects healing and increases the risk of infection. You may undergo nicotine testing to confirm you remain smoke‑free.
- Have stable financial and insurance support — Transplant care involves lifelong medications, frequent appointments, and ongoing monitoring. Social workers will help you understand coverage, costs, and resources so you can maintain long‑term care.
- Have a strong support system — A transplant requires daily help before and after surgery. You must have caregivers who can assist with transportation, medications, meals, home care, and emotional support during your recovery. Many centers require you to identify at least one dedicated caregiver.
- Maintain a healthy BMI and overall health — Your weight, nutrition, muscle strength, and overall physical condition affect your recovery after a transplant.
- Not use alcohol or illicit drugs — Substance use can interfere with healing, medication safety, and long‑term transplant success. Your team may request counseling, treatment programs, or regular screenings to support your recovery.
Getting listed
If the transplant team decides a transplant is in your best interest, they’ll add your name to the national waiting list. Managed by the United Network for Organ Sharing (UNOS), this list matches donor lungs with people who need them most.
What to Expect While Waiting for a Lung Transplant
Once you’re listed, your transplant team will continue to follow you closely. You’ll see your pulmonology team regularly and your transplant surgeon every three months, or more often if needed. You’ll also receive ongoing education and support to help you stay ready for transplant.
How matching works
When donor lungs become available, experts look at several factors to determine the best match:
- How close you are to the donor hospital.
- How sick you are.
- The size of the donor lungs.
- Your blood type.
- Your lung allocation score (LAS).
LAS ranges from 0 to 100, with higher scores matched sooner. Since your LAS can change with your health, your team updates your score regularly to reflect your current condition.
Staying ready
While you wait, you must stay prepared. Your team will ask you to:
- Attend all appointments.
- Continue healthy habits for lung disease and avoid anything that could delay surgery.
- Keep your phone on at all times.
- Stay within a certain distance of the hospital.
- Update them about new symptoms.
These steps help ensure you’re ready the moment a donor lung becomes available.
How long is the wait for a lung transplant?
There’s no set timeline for how long you will wait. Some people wait weeks, while others wait months or longer. Wait times vary based on:
- Donor lung availability.
- Whether you have antibodies that make matching harder.
- Your blood type.
- Your chest size.
- Your LAS.
While you wait, your team will closely monitor you, adjusting your LAS as needed to reflect your current health.
Healthy Habits During Transplant Wait
Healthy habits play a major role in your lung transplant preparation. They help you stay strong, reduce complications, and improve your recovery after surgery.
Make healthy choices
While you can’t control the timing of your transplant, you can control the choices you make to keep your body strong. These lifestyle changes make a meaningful difference during the wait:
- Avoid tobacco and nicotine — You must stay completely nicotine‑free to remain eligible.
- Follow your care team’s diet recommendations — Your team may suggest a balanced diet, staying hydrated, and maintaining a healthy weight. Good nutrition supports your immune system and helps your body handle surgery.
- Practice good hygiene — Wash your hands often, avoid people who are sick, and keep your home clean to reduce infection risk.
- Protect your lungs from irritants — Avoid indoor and outdoor pollutants, secondhand smoke, mold, and chemicals. These can worsen lung disease and increase your infection risk.
- Remain active — Staying active is one of the most important parts of preparing for transplant. If recommended by your care team, light to moderate activity will help strengthen your heart and muscles, reduce stress, and improve recovery after surgery. Your team may recommend walking, gentle stretching, or pulmonary rehabilitation exercises.
- Stay up to date on vaccines — Vaccines help prevent infections that could delay your transplant or make you too sick for surgery.
Manage stress
Waiting for a transplant can be emotionally challenging. Many people feel anxious, frustrated, or uncertain. Remember, you’re not alone, and there are healthy ways to cope.
To stay grounded and emotionally prepared for the journey ahead, manage your stress by:
- Following a routine to maintain structure and purpose.
- Practicing deep breathing and relaxation exercises.
- Staying connected with family, friends, and support groups.
- Talking openly with your transplant team about fears or concerns.
How Does UPMC Support You During the Wait?
UPMC provides a full support system for people on the transplant waiting list. This includes:
- A multidisciplinary team to guide you through every step.
- Compatibility testing and monitoring.
- Ongoing education.
- Prehabilitation.
- Regular follow‑up appointments.
- Support for emotional, social, and financial needs.
Sources
American Lung Association, 10 Simple Steps to Your Healthiest Lungs. Accessed April 2026. https://www.lung.org/blog/10-tips-for-healthy-lungs. Link.
American Society of Transplantation, While Waiting: What to Do While Waiting for Your Transplant. Accessed April 2026. https://www.myast.org/findyourvoice/while-waiting. Link.
Cystic Fibrosis Foundation, What to Do While Waiting for a Transplant: Maintaining Your Health and More. Accessed April 2026. https://www.cff.org/managing-cf/what-do-while-waiting-transplant-maintaining-your-health-and-more. Link.
MedlinePlus, Lung Transplant. Accessed April 2026. https://medlineplus.gov/ency/article/003010.htm. Link.
Pulmonary Hypertension Association, Getting Ready for Your Transplant. Accessed April 2026. https://phassociation.org/pulmonary-hypertension/treatments/transplant-and-procedures/transplant/getting-ready/. Link.