When Dr. Courtwright met with the patient’s wife to recommend another procedure, she surprised him with her response: “You need to look me in the eye and tell me you’re recommending that because you think he is going to get better, not just because you want to keep him alive for another three months.” Dr. Courtwright did believe that his patient could ultimately improve, but he could understand her worry. “That’s where the one-year mortality metrics really create some paradoxical incentives, and the impression of paradoxical incentives,” he said.

In response to these concerns, the Department of Health and Human Services called for comments on a proposal to do away with the one-year metric for transplant program C.M.S. reaccreditation, though the metric will remain in the initial accreditation process. And we continue to know relatively little about how patients are doing beyond whether they are alive or dead. “I could get anyone to a year,” said Dr. Formica. “ But do you get back to work? Do you get back to being with your family? We don’t know.”

Indeed, despite all the clinical data that transplant programs are required to report to regulatory bodies, there is no similarly rigorous tracking of health-related quality of life. One reason is that mortality is easier to measure; the level of functioning that is important to an individual varies from person to person and changes over time.

Perhaps there is no single metric that defines success, said Dr. Hilary Goldberg, who heads the lung transplant program at Brigham and Women’s Hospital in Boston. Sitting with patients in the transplant clinic, trying to help them imagine life after this momentous surgery, she hopes for a more “fluid” system of reporting that is able to weigh factors based on what different people need.

“The question for me becomes, ‘Who is the audience we are trying to satisfy with these metrics?’” she said. Patients, regulators and doctors might all value slightly different measures, which is challenging. “But if we wanted to define the perfect system, it has to be more malleable.”

It’s been almost a year and a half since Ms. Favazza’s transplant. She said it seemed as though she spent all her time returning to the hospital for a clinic visit, a new scan or a procedure. But she can run her daily errands without carting around her oxygen. She no longer needs to worry when she can’t find a parking spot near a store entrance. After years without travel, she is planning a trip to Florida.

Her surgery is a success story by any metric, not just by the one-year mortality measure.

“It’s about being able to breathe and to do what you need to do,” she told me. Then she paused. “No — not just what you need to do, but what you want to do. Being able to do the little things, kids’ birthday parties, Easter. For me, it’s being able to do all of that again.”

Daniela J. Lamas is a pulmonary and critical care physician at Brigham and Women’s Hospital and an instructor at Harvard Medical School.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.

Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.