Great concern for Norway's Crown Princess Mette-MaritThe hard fight back to life! This is what happens with a lung transplant

For a new lung! Crown Princess Mette-Marit is on the transplant list

In 2018, Crown Princess Mette-Marit (52) developed a chronic illness Pulmonary fibrosis diagnosed. It was already clear in December of last year that Crown Prince Haakon's wife would need new lungs. Now, around six months later, the 52-year-old is actually on the transplant list. The Crown Princess has already had to endure a lot to get here and still has a long, grueling road ahead of her.

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How do you get on the waiting list for a new lung?

As the Ludwig Maximilian University of Munich Clinic (LMU Clinic for short) explains on its website, patients not only have to meet numerous conditions before being included on the transplant list (e.g. there must be “non-reversible terminal lung failure”), but also Comprehensive examinations and a detailed information discussion endure.

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According to the LMU Clinic, the preliminary examinations include blood tests, various computer tomography scans as well as examinations by ENT specialists, dentists, dermatologists, urologists or gynecologists and psychologists. Only when all of these examinations have been completed does a committee decide whether the patient will actually be included on the transplant list.

Hoping for a donor organ: How long do you have to wait for a new lung?

Once on the waiting list, patients must “be reachable by telephone at all times, day or night, via mobile or landline”. In addition, the person concerned must report immediately “if there is a temporary (temporary) obstacle to the transplant (e.g. illness, family reasons or a trip that cannot be postponed),” explains the LMU Clinic. And there's a good reason for that. According to the Lung Information Service, a lung usually has to be transplanted in less than twelve hours.

According to the information service, whether a patient has to wait months or even years for a new lung depends on various factors. For example, size, blood group, tissue properties and urgency are crucial when allocating donor organs.

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According to the German Heart Center at the Charité, it is essential that transplant patients prepare both physically and mentally for the operation during the waiting period. The physical condition is “of crucial importance for the success of the treatment”. In addition, according to the LMU Clinic, the state of health must be regularly reassessed by the transplant center.

How does a lung transplant work?

Once a suitable organ has been found, everything has to happen very quickly. According to the LMU Clinic, a so-called removal team immediately heads to the donor to remove the organ and examine whether it is actually suitable for transplantation. At the same time, the recipient is informed and immediately ordered to the hospital and undergoes final examinations.

During the transplant itself, “the diseased lung is released from the chest and removed. After that, first the bronchi, then the pulmonary veins are connected to a piece of the atrium, and finally the pulmonary arteries of the donor lung are connected to the corresponding structures in the recipient,” explains the LMU Clinic.

Whether just one or both lungs are replaced depends on the type of disease. According to the LMU Clinic, until a few years ago unilateral transplantation was “the method of choice for pulmonary fibrosis” – Mette-Marit's disease. However, it has been shown that “problems often arise with the remaining diseased lungs”, which is why “a bilateral lung transplant is often carried out in these cases today”.

How long can you live with a donor lung?

The transplanted patient finds it easier to breathe immediately after waking up and removing the ventilation tube. In total, you have to stay in the hospital for three to four weeks after such an operation, including around three to seven days in the intensive care unit. “Mobilization under intensive physiotherapeutic care” would then begin immediately.

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And how long can people survive with a donor lung? According to the Charité Heart Center, this depends on various factors. On average, survival time after a lung transplant is six to seven years. However, the Lung Information Service adds that “statistically there is a significantly higher survival rate for transplant candidates under the age of 50 than for people over 50.”

Sources used: LMU Clinic, Lung Information Service, German Heart Center at the Charité