Can lungs be transplanted?

The lungs are an important part of our breathing system. When we say that smoking is harmful to health, we often mean that smoking will harm the health of our lungs. After taking X-rays, we found that the lungs of many heavy smokers are dark brown or black. Lung disease is a common condition. Transplantation is now an advanced technology for treating diseases. So for lung diseases, can we use transplantation as a treatment method?

Can. Chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), cystic fibrosis, alpha-1 antitrypsin deficiency, and idiopathic pulmonary hypertension account for 85% of the entire lung transplant disease spectrum. The remaining 15% is made up of relatively small numbers of diseases such as sarcoidosis and pulmonary lymphangioleiomyomatosis. Over the past 15 years, with the gradual maturity of lung transplantation technology, donor preservation and perioperative management, the one-year survival rate of lung transplantation has increased from 70% to 85%.

Lung transplant disease types

The main ones are: chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), cystic fibrosis, α-1 antitrypsin deficiency, and idiopathic pulmonary hypertension. These diseases account for 85% of the entire lung transplant disease spectrum. The remaining 15% is made up of relatively small numbers of diseases such as sarcoidosis and pulmonary lymphangioleiomyomatosis. The International Society for Heart and Lung Transplantation maintains a detailed registry of more than 23,000 patients from more than 100 transplant centers worldwide.

Indications for lung transplantation

The general indications for lung transplant recipients are: severe functional impairment due to terminal benign lung disease, ineffectiveness of medical drugs and general surgical treatments, severe limitation of daily activities, life expectancy of only 1-2 years, and no other important organ failure. The recipient selection criteria jointly developed by the American Association of Thoracic Surgeons and the International Heart and Lung Transplantation Society are: appropriate age (see below) 55 years old for heart-lung transplantation, 65 years old for single-lung transplantation, and 60 years old for double-lung transplantation; severe clinical and physiological diseases; ineffective or lack of drug treatment; limited life expectancy; ideal nutritional status; satisfactory social and psychological status and ability to control emotions.

There are four general types of lung transplantation: single lung transplantation, double lung transplantation, heart-lung transplantation, and living donor lobar transplantation. The choice of surgical approach is influenced by many factors, including the recipient's disease, age, severity of illness, experience of the transplant center, and scarcity of donors. The perioperative management of patients with idiopathic pulmonary hypertension after single lung transplantation is relatively difficult, so many people advocate double lung transplantation or combined heart-lung transplantation. For infectious diseases such as cystic fibrosis and bronchiectasis, double lung transplantation is currently advocated because the autologous lung on the other side is a very serious source of infection, which can have a serious impact on the transplanted donor lung and the subsequent quality of life.