Can You Get A Lung Transplant With Lung Cancer?

Recently, we had the opportunity to provide care for a patient in his early 60s diagnosed with severe, end-stage COPD—now categorized simply as severe COPD. Recognizing the severity of his condition, one of my more brilliant coworkers had a thought: why wouldn't he be a candidate for a lung transplant? Intrigued, my coworker delved into the intricacies of lung transplantation and uncovered a surprising answer.

As his investigation progressed, a crucial piece of information emerged—this patient had lung cancer. The revelation left my coworkers and me questioning why individuals with lung cancer are often excluded from the lung transplant list. One hypothesis we formulated was the uncertainty surrounding metastasis—after all, there's no guarantee that the cancer hasn't spread beyond the lungs.

In our exploration, we confirmed that uncertainty about metastasis was indeed one of the reasons lung cancer patients are often excluded from the transplant list. However, our journey into the intricacies of lung transplantation unveiled additional contributing factors. It became apparent that individuals undergoing lung transplants also need medications to suppress the immune response, preventing the immune system from attacking the new set of lungs. Should the lung cancer recur, the immuno-suppressed state required for organ transplantation could significantly complicate the management and treatment of the recurring cancer.

Moreover, the lung transplant waiting list is teeming with individuals eagerly awaiting this life-changing opportunity. Coupled with the inherent limitations in organ availability, the ethical dilemma intensifies. Allocating a fresh set of lungs to someone with a history of lung cancer becomes increasingly challenging, considering the pressing demand and the responsibility to maximize the benefits of available organs for the broader population.