The lungs are responsible for breathing. When inhaled, it fills with air via the trachea and bronchi. The gas exchange between blood and air then takes place in the pulmonary alveoli: the blood is enriched with oxygen from the breathing air in order to supply the organs. At the same time, carbon dioxide is removed from the blood – a waste product that is carried from the organs to the lungs and exhaled.
The lung consists of a right and a left lung. These in turn consist of a total of five lung lobes – three in the right lung and two in the left lung.
Reasons for a transplant
Many diseases damage the lungs so severely that gas exchange can no longer take place adequately. This has serious effects on the life expectancy and quality of life of those affected, who experience shortness of breath even with the slightest physical exertion. In many cases there is a risk of complete lung failure, after which those affected must be artificially ventilated.
When all medical and surgical options have been exhausted, patients are placed on the waiting list for a lung transplant. The following diseases are the most common:
Fibrosis refers to scarring of the lung tissue. Numerous diseases, such as pneumonia, can lead to increased connective tissue forming between the alveoli and blood vessels, which reduces the surface area for gas exchange and less and less oxygen is absorbed.
Chronic obstructive pulmonary disease (COPD):
Several diseases cause the bronchi to become inflamed and narrow, which impedes the airflow of breathing. Exhaling against this constriction becomes increasingly difficult, the lungs overinflate and pulmonary bubbles form (emphysema). Here, too, the effect is a reduction in the area of the lungs through which oxygen can be absorbed.
An inherited disease that affects the whole body, as a result of which the secretions of certain glands contain too little water and are therefore too viscous to perform their functions in the organs. The bronchi are also affected, which is why the susceptibility to pneumonia increases. Emphysema can also occur here.
Depending on the severity of the condition, either an entire lung or just one lung is transplanted, leaving the recipient with a lung of their own. Both procedures are postmortem transplants and occur with about the same frequency.
Frequency and prospects of success
In the case of the lungs, the overall downward trend in organ donation is weakest. In 2011, 337 transplants were performed. After a slight increase in the following years, the number fell to 328 in 2016. In contrast, 390 patients were on the waiting list for a donor organ as of December 31, 2016.
Three years after a transplant, an average of 65 percent of organ recipients are still alive.
In the case of lung transplants, there is the special case of the domino donation: In such cases, for operational reasons, it is necessary to transplant the lung only together with the heart. The patients not only get the lungs, but also the heart of the donor. If your own heart is still healthy, it can be transplanted to another patient after it has been removed.
Three years after a heart-lung transplant, an average of 55 percent of recipients are still alive.
In principle, a living donation of individual lung lobes is possible. In this case, patients receive two intact lung lobes from a donor. However, living lung donation is considered to be very risky for the donor, which is why it is only carried out in a few transplantation centers worldwide and is not part of the standard in Germany.