Initially, this procedure was a last resort to rescue a dying child, one too weak to survive the rare opportunity of a cadaveric lung of the right size. It still is not the preferred procedure. Neonates, children, and adults of small stature frequently have a difficult time receiving cadaveric donors because of the small pool of similarly sized donors. Living related lobar transplants provide an alternate source of organs if the patient cannot survive until a cadaveric donor is found. The human lung is divided into five lobes, three on the right side and two on the left.
Some transplants just replace the diseased lobes.
However, cystic fibrosis patients must have all of their lungs removed when they are transplanted or they risk infecting the new lung tissue. The donor lobes must be large enough to expand and fill the native lung space. The biggest problem with living related lobar transplants is that up to two healthy people have to undergo major surgery with some loss in lung function incurred in order to benefit one very unhealthy recipient. They also have a significant recovery time with subsequent loss of wages. This poses an ethical dilemma for doctors who are put in the position of putting two lives at risk.