Question

Live donor lung transplantation.

Hint:

Live donor lung transplantation offers an alternative to deceased donor transplants, but it involves significant risks to both the donor and recipient. Careful donor selection and post-operative monitoring are crucial.

Answer 1

Live donor lung transplantation is a rare and specialized procedure where a portion of the lung from a living donor is transplanted into a recipient with end-stage lung disease. It is an alternative when cadaveric donor lungs are unavailable or when waiting lists are long.
Step 1: Indications for Live Donor Lung Transplantation:
- Shortage of Organ Donors: The most common reason for considering live donor lung transplantation is the shortage of cadaveric donor organs.
- Pediatric and Small Adult Recipients: Live donor lung transplants are more frequently performed in pediatric and small adult patients where the lung size match is critical.
- Urgency and Acute Conditions: In urgent situations, where a recipient’s condition is deteriorating rapidly, a live donor lung transplant can provide timely treatment.
Step 2: Donor and Recipient Selection:
The donor must be healthy with no history of smoking, lung disease, or respiratory infections. Ideally, the donor’s lung size and anatomy should be compatible with the recipient. In general, the procedure involves removing one lobe of the lung from the donor, usually the lower lobe, and transplanting it into the recipient.
Step 3: Surgical Procedure:
The donor and recipient undergo surgery simultaneously. The donor’s lung lobe is removed through an incision, and the lung is transplanted into the recipient. This surgery requires careful planning to ensure both the donor and recipient recover properly, and the recipient receives enough lung volume to maintain normal respiratory function.
Step 4: Risks and Challenges:
- Donor Risks: Risks to the living donor include complications from lung resection, such as infection, bleeding, and reduced lung function post-surgery.
- Recipient Risks: For the recipient, the main risks include graft rejection, infection, and complications related to the surgical procedure. Long-term survival depends on the proper function of the transplanted lung and management of immune suppression.