Lung transplantation offers a life-altering treatment for individuals facing severe lung disease. While many organ transplants rely on deceased donors, a lesser-known option involves living individuals donating a portion of their lungs. This specialized procedure allows family members, and sometimes others, to contribute directly to a loved one’s recovery, offering a planned and potentially faster route to transplantation.
Understanding Living Lung Donation
Living lung donation differs significantly from whole organ donation. Donors contribute one or more lobes, which are segments of their lungs, rather than an entire lung. The human right lung has three lobes, and the left lung has two. Typically, a recipient receives two lobes, often one lower lobe from each of two separate living donors. This is medically feasible because the remaining lung tissue in the donor can expand to fill the space, allowing them to maintain adequate lung function.
Donor Eligibility Requirements
Becoming a living lung donor requires meeting strict health and compatibility criteria to ensure the safety of both the donor and the recipient. Potential donors are generally between 18 and 64 years old, with an ideal age range of 25-40 years. Candidates must be in excellent physical and mental health, with no history of chronic conditions like heart disease, diabetes, or active infections.
A non-smoking history is important, and healthy lung function is assessed. Compatibility also extends to blood type and, ideally, tissue type to minimize recipient rejection. A comprehensive psychological evaluation ensures the donor understands the risks and makes an informed, voluntary decision.
The Donation and Transplant Process
The donor journey begins with an extensive evaluation, including medical tests, imaging scans, and consultations. This confirms the donor’s suitability for surgery. Once approved, the donation and transplant can be scheduled, offering an advantage over the unpredictable wait for a deceased donor organ.
During surgery, the donor undergoes a lobectomy, where a lung lobe is removed. Simultaneously, the recipient’s diseased lungs are removed and replaced with the donated lobes. The entire procedure typically lasts several hours. After surgery, both are monitored in an intensive care unit, with chest tubes often in place for several days.
Potential Donor Risks and Recovery
Living lung donation involves inherent risks for the donor. General surgical complications, such as infection, bleeding, pain, and adverse reactions to anesthesia, are possible. Specific risks include pneumothorax (collapsed lung), pneumonia, and persistent incision site pain.
Donors may experience a 10% to 20% reduction in lung function, though this typically does not impact daily activities. The typical hospital stay for a donor ranges from 4 to 10 days. Full recovery, including returning to work and normal activities, usually takes between 4 to 12 weeks. Donor mortality is rare.
Alternatives When Living Donation Isn’t Feasible
When living lung donation is not an option, the primary alternative is deceased donor transplantation. Patients are placed on a national waiting list, managed by organizations like the United Network for Organ Sharing (UNOS) in the United States. Organ allocation is a complex process based on factors such as blood type, body size, medical urgency, and geographic proximity, not just time on the list. Waiting times vary significantly, from days to several years. For some patients with specific lung conditions like severe emphysema, alternatives such as Lung Volume Reduction Surgery (LVRS) may be considered to improve lung function and quality of life.