Harefield Hospital is now offering lung transplants using parts of the lung from living donors. This pioneering procedure is offered in very few centres around the world, due to the complexity of surgery and level of care required.
Lung transplantation is often the last resort for patients who suffer from end-stage lung disease. The most common reasons for lung transplantation include chronic obstructive pulmonary disease (COPD), cystic fibrosis, idiopathic pulmonary fibrosis and pulmonary hypertension. Approximately 230 patients are currently on the waiting list for a new lung. This new procedure, therefore, offers new hope to hundreds of patients and their families.
A lung lobe transplant differs from traditional lung transplants in that it uses part of the lung from two living donors (called a ‘lung lobe’), rather than healthy lung(s) from a donor who has been pronounced brain dead.
As usually two donors are needed to each donate one lobe, the transplant typically involves three operations, one on each of the two donors and one on the recipient.
The surgery begins with one of the lower lobes being removed from each of the donors, leaving them with four lung lobes. The remaining lung tissue will expand to occupy the space left by the donated lobe. The recipient will have both of their diseased lungs removed and receives the two new lung lobes: one from each donor. While lung function will not be 100% right away, after two years it should be comparable to those receiving conventional transplants. Two lung lobes have the ability to provide a near normal lung function.
Donors are usually required to be close blood relatives. However, in some cases, spouses or close friends may also donate pending prior approval from the Unrelated Live transplant Regulatory authority (ULtRa). They are then tested to determine suitability, according to blood type and lung function capacity.
Donors must have extensive counselling to make sure they understand the risks, both in terms of morbidity and mortality. The risks are small but are spelt out in detail and written information is given to the donor.
Donors are usually up and walking two days post-operatively and can be discharged in a few weeks. They will experience post-operative pain and will have a chest tube for a short while after the operation, but long-term effects are minimal to none.
Given that this new procedure involved operating on two healthy patients, surgeons at Harefield initially found this a difficult operation to contemplate. However, after much consideration, the team at Royal Brompton and Harefield Hospitals thought that operating on two people to save the life of a critically ill other was a worthwhile cause. There was also considerable pressure brought by the relatives of sick patients for this procedure to be made available.
The Harefield Hospital transplant team, led by surgeon André Simon, is one of the largest and most experienced centres in the world for heart and lung transplants. As André Simon and his team pursue live-donor transplants for patients, families, spouses and friends will look to this procedure as a new opportunity for hope.
If you would like to find out more about the procedure, or to book a consultation with Dr Simon, please call: 02031 312 595 or email: privatepatients@rbht.nhs.uk
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