Yes, it is possible for a person to live with only one lung, a reality achieved through a procedure known as a pneumonectomy. This major surgery involves the complete removal of either the right or left lung. The human body possesses remarkable adaptive mechanisms that allow the remaining single lung to take over the function of both, effectively sustaining life. The path to recovery involves significant physiological changes and subsequent lifestyle adjustments that allow the individual to maintain most daily activities.
Medical Necessity for Removing a Lung
The decision to remove an entire lung is always a measure of last resort, reserved for life-threatening conditions where preserving the lung is not possible. The most common indication for a pneumonectomy is aggressive, centrally located lung cancer, such as non-small cell lung cancer, which cannot be removed with a less extensive procedure like a lobectomy. This surgery ensures the complete removal of the malignancy when it has spread across crucial airways or is too large to be contained.
Severe, non-cancerous conditions also necessitate the procedure, including extensive traumatic lung injuries, particularly those involving crushing or penetrating wounds that cause irreparable damage. Chronic, destructive lung infections like advanced tuberculosis or complex fungal infections that are unresponsive to aggressive medical treatment may also require removal. The procedure is only performed after a rigorous assessment confirms that the remaining lung is healthy enough to support life independently.
Physiological Compensation of the Remaining Lung
Survival with a single lung is possible due to anatomical and physiological changes that maximize the efficiency of the remaining organ. The most immediate mechanical change is the compensatory expansion, or hyperinflation, of the remaining lung tissue, which begins to fill the space left by the removed lung. This expansion recruits previously unused alveoli to increase the available surface area for gas exchange.
The empty chest cavity causes the mediastinum—the central compartment containing the heart and major blood vessels—to shift toward the side of the removed lung. This shift, along with the elevation of the diaphragm on the operative side, helps reduce the vacant space and allows the remaining lung to fully inflate. Simultaneously, the entire cardiac output, which previously went to both lungs, is redirected to the single remaining lung, effectively doubling its perfusion.
This increased perfusion, combined with the greater surface area from hyperinflation, enhances the efficiency of gas exchange within the alveolar-capillary network. This adaptation allows the patient to maintain normal blood gas levels at rest. While overall lung function decreases by around 30% to 40% immediately following the procedure, the body compensates by increasing both the rate and depth of breathing, especially during physical activity.
Adjusting to Life with Reduced Lung Capacity
Individuals living with one lung generally experience a reduction in their exercise capacity due to diminished respiratory reserve. While they are able to resume normal, day-to-day activities, they frequently experience shortness of breath (dyspnea) when engaging in strenuous physical exertion. This limitation results from the remaining lung reaching its maximum capacity more quickly than two lungs would.
Long-term management requires strict adherence to lifestyle modifications focused on protecting the single lung from damage and infection. Avoiding all forms of smoking and minimizing exposure to airborne irritants is paramount, as a respiratory infection in the remaining lung can become life-threatening. Patients often engage in pulmonary rehabilitation, a medically supervised program that includes exercise training and breathing techniques to optimize the efficiency of the remaining lung.
Patients also require specialized, ongoing medical follow-up to monitor for potential long-term complications, such as pulmonary hypertension (high blood pressure in the arteries of the lung). The continuous redirection of all blood flow through the single lung increases the workload on the right side of the heart. The severity of functional limitations varies significantly depending on the patient’s age and overall health before the surgery.