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In a few weeks, Rabin Medical Center surgeons are due to become the first in Israel to perform a lung transplant from a live donor, The Jerusalem Post has learned. The delicate procedure, which requires two relatives of the recipient each giving one of his/her lower lobes, will save lives of lung disease victims waiting a long time for a cadaver lung.
Prof. Mordechai Kramer, head of the pulmonology institute at the Rabin Medical Center-Beilinson Campus in Petah Tikva, told the Post that the procedure has been performed so far only about 300 times since it was developed by an American surgeon in 1992. Most of the transplants have been performed in Japan and in Los Angeles.
The removal of lung lobes (every person has three on the right side and two on the left) and their transplant into patients suffering from cystic fibrosis, lung cancer, an infection or other lung disease, has received approval in principle from the Health Ministry.
There is some risk to the donor from the general anesthesia, like any one-and-a-half-hour operation, as the lung lobe cannot be removed by minimally invasive surgery. But the complication rate is very low.
The transplant surgery, which takes about six hours, is not very different from the 191 lung transplants that have already been performed at Beilinson, Kramer said.
The donor loses about 15 percent to 20% of his lung capacity, with which he can live very well. Unlike transplants of a lobe of liver from a live donor, in which the liver grows back to its original size, this does not happen with the donation of a lung lobe.
Although Beilinson thoracic surgeons perform 250 operations a year to remove cancerous lungs, and the removal of a healthy lobe is not very different (except that blood vessels attached to the lobe have to be preserved), Kramer said the hospital will invite Prof. Hiroshi Date of Japan, who had performed numerous live-donor transplants, to participate in the first one at Beilinson just in case.
Due to the shortage of cadaver lungs, which are transplanted one or two at a time, the live-donor transplant is the solution for many patients. There is no age limit for donors, Kramer said, but the lobes must be of a suitable size, as very small lobes will not suffice for a large recipient. He added that the donations will be made for altruistic reasons, and that he doubts a "black market" with for-payment donations will arise, as taking the lobe involves a more serious operation than taking a kidney or liver lobe.
The Beilinson team will include Dr. Binyamin Medallion, a senior cardiothoracic surgeon, and Dr. Milton Saute, head of the lung surgery department.