National Transplant Day is celebrated on the last Wednesday of March, a date promoted by the National Transplant Organization with the aim of promoting a culture of organ donation and giving a chance at life to patients waiting. Many of these patients are chronic or terminal. For them, donations and transplants are their last alternative for life.

“Transplant recipients have two reasons to be grateful: National Donor Day, on which they have been expressing their gratitude to donors and encouraging donation for many years; and National Transplant Day, which is to thank and encourage the professionals who make it possible to continue their line of improvement, in quantity and quality. Many people are mobilized for a transplant. This day is an opportunity for transplant recipients to publicly express their gratitude.”

National Transplant Day - Spanish Federation of Cystic Fibrosis (FEFQ)

 According to the National Transplant Organization (ONT), 2020 transplants were performed in Spain in 4425. Of these, 336 were lung transplants.

If we talk about lung transplants, in our country there are a number of hospitals that are references and the Vall d'Hebron Hospital in Barcelona is one of them, as it continues to be the leader in the number of lung transplants according to data from 2020.

In the past year, and due to the COVID-19 pandemic, the number of operations has decreased and the waiting list for transplants has increased in length. In addition, patient follow-up has been mostly done online.

The number of patients who need and are waiting for a transplant is greater than the number of available donors. About 10% of the total are still waiting to receive their transplant.

Of the total number of patients on a waiting list or receiving a transplant, 5% are pediatric patients.

The waiting process to find a compatible donor and perform the procedure can be very long. In Spain, it usually takes an average of 250 days, while in England, it is 326 days.

The most common pathologies in patients who receive a lung transplant are: Chronic Obstructive Pulmonary Disease (COPD), Pulmonary Fibrosis, Pulmonary Hypertension, Bronchiectasis, Alpha-1 Antitrypsin, or Cystic Fibrosis, as the disease causing the highest percentage of transplants in pediatric age.

 

What types of lung transplants are there?

  • Single lung transplant: transplantation of one lung.
  • Double lung transplant: transplant of both lungs.
  • Cardiopulmonary transplant: transplant of both lungs and the heart.
  • Lobar transplant: transplant of part of a lung. The recipient is usually a child.

General indications for transplantation

Source: Clinical evaluation and review procedures for patients who are candidates for lung transplant. Pilar Morales Marín, Antonio Román Broto. SEPAR Procedure Manual, 15.

Clinical indications for transplantation

The clinical indications for a lung transplant are:

  • Functional stage for dyspnea III-IV / IV (small efforts – rest)
  • Partial or global respiratory failure.
  • Respiratory function examination: FVC, FEV1 > 30% (except in pulmonary hypertension, hemoptysis or refractory pneumothorax, pulmonary thromboembolism)
  • Repeated life-threatening hospitalizations, ICU admissions
  • Clinical deterioration: Repeated infections, weight loss.

Source: Clinical evaluation and review procedures for patients who are candidates for lung transplant. Pilar Morales Marín, Antonio Román Broto. SEPAR Procedure Manual, 15.

 Absolute contraindications

  • Active addictions in the last 6 months (tobacco, alcohol, drugs). The possibility of implementing rehabilitation programs will be considered.
  • Malignancy in the last 2 years with the exception of squamous cell carcinoma of the skin and basal cell carcinoma. 5 years disease-free is advisable.
  • Progressive neuromuscular disease / severe osteoporosis
  • Significant chest deformities
  • Irreversible damage to a vital organ (brain, kidney, liver, heart) Non-revascularizable coronary disease or associated with left ventricular dysfunction.
  • Chronic active hepatitis B or C.
  • HIV infection
  • Severe psychiatric pathology associated with inability to cooperate or comply with treatment or documented therapeutic non-adherence.
  • Prolonged invasive mechanical ventilation.

Source: Clinical evaluation and review procedures for patients who are candidates for lung transplant. Pilar Morales Marín, Antonio Román Broto. SEPAR Procedure Manual, 15.

 Physiotherapy in the pre-transplant phase

Patients who opt for a transplant have some characteristics in common, such as:

  • Respiratory insufficiency
  • Poor tolerance to aerobic exercise
  • Limiting dyspnea
  • Immobility
  • General loss of muscle mass.

Respiratory physiotherapy is an important part of pulmonary rehabilitation for transplant patients. The physiotherapist begins to work with the person receiving the transplant in the pre-transplant phase so that they are in good condition and then for their recovery. This treatment will be adapted to the needs of each person at each stage of the process.

The respiratory physiotherapist will help the patient in various aspects such as the respiratory part and the physical part.

  • Respiratory physiotherapy through maneuvers that can be manual or instrumental, some of these exercises will be:
    • Directed ventilation exercises
    • Exercises to control breathing rhythm (mixing slow and fast breaths), inspiratory volumes (the amount of air taken in when breathing) and speed of expiratory flows (speed at which air is expelled during breathing)
    • Abdominal-diphragmatic breathing exercises: Breathe by directing the air towards the abdomen, inflating the belly as if you wanted to pop the button on your pants.
    • Costal expansions.
    • Secretion drainage exercises for bronchial cleansing.
  • Muscle strengthening:
    • With 1-2 kg weights, the main muscles in both limbs are worked.
      • Upper or Arms: Pectoral, deltoid, trapezius, latissimus dorsi, biceps and triceps.
      • Lower or Legs: Quadriceps, glutes and triceps surae.
    • Balance exercises while sitting and standing.
    • Active leg exercises
  • Aerobic training on a stationary bike and/or treadmill with saturation control.

After 3-4 weeks, the patient learns the exercise routine, and depending on his progress, the professional will indicate the next steps. He must remain as active as possible with the help of supplemental oxygen if necessary.

More information on this topic and National Transplant Day:

The team of respiratory physiotherapists at Fundación Lovexair is available to answer questions or queries. You can also join the insp@ir community to connect with other people who share your same concerns about lung health.

Last updated on 7 March, 2026