What is a Living Lung Donor?

What are the Lungs?
The Lungs are paired organs in the chest that perform respiration. Every person has two lungs that is between 10 and 12 inches long. The two lungs are separated by a structure called the mediastinum. The mediastinum contains the heart, trachea, esophagus, and blood vessels. The lungs are covered by a protective membrane called the pulmonary pleura.

The Lung is a paired organ, divided into anatomically separately halves, called lobes.  There are 3 lobes on the right and 2 on the left.

What do your Lungs do?
Your lungs do a vital job. Each day, you take about 23,000 breaths, which bring almost 10,000 quarts of air into your lungs. The air that you breath in contains several gases, including oxygen, that your cells need to function. With each breath, your lungs add fresh oxygen to your blood, which then carries it to your cells. The main function of your lungs is respiration.

Why are Lung Transplants needed?
Lung transplants are given to people as a last resort treatment for irreversible lung failure. Lung failure happens when the lungs are damaged and unable to transfer oxygen and carbon dioxide to and away from cells. Some of the diseases which may cause lung failure include emphysema, cystic fibrosis and pulmonary fibrosis. 

In 2005, approximately 3,500 people in the U.S. were waiting for a lung transplant, yet only 1,000 of them (25 percent) received a transplant. Improvements in surgical techniques have led to an increase in the number of people waiting for lung transplants and it has outpaced the number of available donors.  Because of this deficit in cadaveric lung donation, live lung donation has become increasingly popular. 

Advantages of Live Lung Transplants
Living lung transplants are advantageous because recipients do not have to wait on a list and the transplant can be scheduled at a time convenient for both parties. In addition, the recipient can begin to take immunosuppressive medication earlier, which decreases the chances of rejection. Living lung transplants tend also to be more successful because there is a closer match between the donor and recipient.

Becoming a Lung Donor
The following may be required as part of the screening process:

• Blood-type/ lung-size compatibility
• Chest x-ray, high-resolution chest ct
• ECG, echocardiography, ventilation/perfusion scan
• Spirometry, blood gases, sputum culture, viral serology

The following are the general criteria for an acceptable live donor:

• Under 55 years of age
• No significant past medical history
• No recent viral infections
• Normal chest x-ray, and ECG cardio echo
• No previous thoracic surgery on donor side
• No significant abnormality on chest CT

The Donation Process
One of the lower lobes is removed from the donor, leaving the donor with 4 lobes.  The lung lobe does not revitalize, but the remaining lung tissue expands to occupy the donated region.  The recipient has both his/her diseased lungs removed and receives two new lung lobes; one lobe from two separate donors.  The lung function of the recipient at two years is comparable with those receiving conventional transplantation from a brain stem dead donor with five lobes.

Illustration demonstrating the portion of each donor lung to be transplanted into patient recipient.The two lobes have the ability to provide normal function, accounting for the increasing popularity of this type of transplantation.

All donors will experience some post-operative pain and will have a chest tube  for at least a few days after the operation. There is also a small risk of postoperative infections and other, rare, postoperative complications.  In a study of 253 donor lobectomies there were no preoperative or long-term deaths.  80.2% had no preoperative complications and 19.8% had one more complications. 

Most donors are hospitalized for about nine days. The total recovery time is likely to be four to six weeks, during which the donor will be unable to work or care for other family members.

A donor with four lung lobes instead of five lung lobes will have less exercise tolerance for competitive sports, but will be able to live a normal life in all other respects

Financial Ramifications
All the pre-operative testing, the transplant surgery and the post-operative care should be provided for by the organ recipients insurance. It is legal for the recipient to cover the donors cost related to the operation, which may include travel expenses, lodging and lost wages due to time away from work. Live donorship should not change a donor’s life, disability, and health insurance cost. Contact you insurance agent to verify this.

Psychological Benefits
The sense of satisfaction at having saved someone’s life cannot be measured by words. This sense of generosity is compounded because another person with lung failure, completely unknown to them, will be able to receive a cadaver set of lungs from the transplant waiting list that the recipient would have needed without living donation

Making the Decision
Deciding to become a lung donor is a one of the most altruistic gifts that one can give. It is a significant decision for both you and the recipient. To ensure you make this decision fully informed, review the following:

Below are some questions to guide you in the process

How do I feel about organ donation?
Do I know enough to make a logical and educated decision?
Am I being psychologically pressured to be a living donor?
Am I fully informed about the medical risks involved?
Am I up to it physically?
Do I have a “support network” to help me through this process?
Am I prepared to deal with the possible rejection of the organ?

Confidentiality:
The HOD Society will not share personal information with either party without prior consent from both parties. The HOD Society may share basic medical information, such as blood type, to determine preliminary compatibility of the parties

Liability:
The HOD Society simply shares contact information with permission of both parties and is not responsible for any events that consequently occur. You are solely responsible for your interactions that take place after the transfer of contact information.  HODS makes no representations or warranties as to the conduct of any interactions. In no event shall HODS be liable for any damages whatsoever, whether direct, indirect, general, special, compensatory, consequential, and/or incidental, arising out of or relating to the conduct of you or anyone else, including without limitation, bodily injury, emotional distress, and/or any other damages resulting from communications or meetings.  You agree to take reasonable precautions in all interactions.