A Review of Lung Transplantation and Its Implications for the Acute Inpatient Rehabilitation Team

Since the late 1980s, lung transplantation has become an option for some individuals (in 2014, 4000 lung transplantations were performed) with end-stage lung disease aimed to help these individuals restore function and improve survival and quality of life. Individuals living with end-stage lung disease already are deconditioned, with poor endurance and limited exercise capacity. There are additional post-transplantation factors that can contribute to poor endurance and decreased exercise capacity. Although pulmonary rehabilitation in the pretransplantation phase is a crucial component for positive functional outcomes after lung transplantation, the incidence of post-transplantation complications, coupled with the need for immunosuppression, often warrants close monitoring by medical professionals. The acute inpatient rehabilitation unit offers an ideal setting for such patients to receive therapies to improve functional status while allowing for monitoring and medical management with a comprehensive team approach, including both the rehabilitation and the transplantation teams. In this article, we review the medical issues, physiologic changes, common complications after lung transplantation, and potential side effects of immunosuppressant therapy, as well as address rehabilitation specific concerns, outcomes, and goals of the patient undergoing lung transplantation in the acute inpatient rehabilitation unit.