A lung transplant is a surgery to replace one or both diseased lungs with healthy lungs from a human donor. The new lung or lungs are usually donated by an organ donor under age 65 who is brain dead but is still on life-support, but may also be donated by living donors. Living-donor lung transplant require two or more donors, with each donor giving a segment (lobe) of their lung to form an entire lung for the person who is receiving it.
The lungs play a critical role in the body, extracting oxygen from inhaled air for distribution via the bloodstream to every cell in the body. Conversely, during exhalation the lungs expel waste — carbon dioxide produced when cells use oxygen. When lungs become diseased, they no longer can maintain the necessary exchange of oxygen and carbon dioxide.
Lung transplantation can prolong and dramatically improve the quality of life for patients with severe end-stage, non-malignant pulmonary disease and no alternative treatment options. A number of diseases and conditions can cause lungs to become so dysfunctional that one or both of them may need to be replaced through transplantation. These can include:
- Chronic Obstructive Disease (COPD)
Includes chronic bronchitis and emphysema, involves obstruction of airflow through the airways and out of the lungs and it is usually permanent and progressive.
- Pulmonary Fibrosis or Interstitial Lung Disease (ILD)
ILD is a general term that includes a number of chronic lung disorders which cause the walls of the air sac to become inflamed and then scar (pulmonary fibrosis) and may involve the tissue between the air sacs (interstitium). This causes the lungs to become stiff and smaller in volume.
- Cystic Fibrosis
This genetic disease is characterized by the production of abnormal secretions leading to mucus build-up that impairs lung function.
- Bronchiectasis
A disorder in which the airways become enlarged and distended, forming pockets where infection can develop. The lining of the airways become altered, which damages the lung’s cleaning system and allows dust, mucus and bacteria to accumulate and infection to occur.
- Pulmonary Hypertension
A rare disorder in which increased pressure in pulmonary circulation can cause permanent damage to the lungs, a situation that ultimately becomes life-threatening. When there is no known cause, it is called primary pulmonary hypertension. Pulmonary hypertension that occurs as a result of other disorders is called secondary pulmonary hypertension. Pulmonary hypertension caused by abnormal development and defects in the heart and great vessels is called Eisenmenger’s syndrome.
- Sarcoidosis
A systemic disease in which chronic inflammation causes granulomas (small lumps) to develop in body tissues — often in the lungs.
- Lymphangioleiomyomatosis
A rare disease characterized by an overgrowth of muscle cells that causes obstruction of the airways and blood and lymph vessels.
Like all organ transplant recipients, people receiving a lung transplant must take anti-rejection drugs to suppress the immune system and keep it from attacking the transplanted lung as an invader. These drugs must be taken for the life of the patient to prevent rejection. Suppressing the immune system long term, however, makes the recipient vulnerable to infections and cancers that would not otherwise be a problem. In addition, the drugs themselves have side effects ranging from osteoporosis, appearance changes, cardiovascular disease and kidney damage. The cost of drugs and treatment generally run between $25,000 and $45,000 per year for the life of the patient.