 Joining us to talk about your health is Dr. Robert Reed, Medical Director of the University of Maryland Medical Center Lung Transplant Program and Professor of Medicine at the University of Maryland School of Medicine. Doctor, good to see you again. Oh, thanks. Thanks for remembering. Indeed, this is National Donate Life Month. And transplants, of course, have become routine just over the last few decades. But they can't be done without a donor. That's correct. It really takes a major commitment. And the donor is where it all starts. It really is the one good thing that can come out of a tragedy for a lot of families that are going through what families go through when there's a donation. And it's Donate Life Month because it's spring. And spring is the time when winter turns into spring, and life begins anew. What are the top conditions that lead somebody to wind up on the list for a lung transplant? Well, the most common reasons to experience the respiratory failure that people get that makes them need a lung transplant are pulmonary fibrosis, which is a scarring condition of the lungs. Chronic obstructive pulmonary disease typically a smoking-associated condition. And then there are a whole bunch of other conditions like pulmonary hypertension, which is a disease of the blood vessels of the lung. Orcystic fibrosis is a genetic condition that often leads to a lung transplant as well. Any positive trends as fewer people smoke as medical therapy advances? Are you seeing any change in the number of people who wind up on that transplant list? Gosh, I think that one of the real remarkable breakthroughs has come with cystic fibrosis. There was a tremendous drug, tricafta, that came out. And it really took a lot of people that were quite sick and waiting for lung transplants and made them healthy and so healthy, in fact, that they no longer needed a lung transplant at all. Thousands of Marylanders are on the transplant waiting list. What would you say to donors to make people, if they haven't done it on their driver's license, rethink that decision? That's right. It's easy to sign up. It's as easy as making that decision when you go and get your driver's license if you didn't make that decision, if you were thinking of other things when you were in line, that makes sense. You can go to registerme.org online and do that. Or it's also an important step to just have that conversation with your family. It can sometimes be unsettling for a family to find out that you weren't organ donor for the first time when they're facing the tragedy of your passing. And to have that conversation ahead of time prepares them for it and allows them to see it as comforting. Yeah, let me remind our viewers if you have a question about lung disease, lung transplants, give us a call at the number on the screen or send an email to livequestionsatmpt.org. When prospective donors have a question about signing up, do they wanna make that call? Do they wanna check the box? What are some of the concerns that you might hear from them about the process of this? Gosh, I've had that conversation with a number of people and some people just don't trust the system. This system is a big complex system with a lot of logistics, yes. But it's one that's really designed to try to get the maximum benefit for the most people possible. It's really trying to help people. What's been the impact of COVID on your profession? I mean, as a pulmonologist, you see people, I imagine whose lungs were damaged from the disease. Did any of them wind up getting transplants? They sure did. We had a number of patients who were otherwise young and healthy and they got COVID and like so many others during the pandemic, their lungs were destroyed. And a few of those we were able to help without a transplant, but there were several whose lungs were just irreparably destroyed and we transplanted several and they're doing great today. How do, generally speaking, recipients of a lung transplant do over the intermediate term and the longer term? Well, it's a high risk, high reward situation medically. It is a condition where you have to take medications for the rest of your life. If you decide you're gonna take a few weeks off, the lung rejects and then you're back into a state where you can't breathe and you're in trouble. But if you're committed to it, it can be, the analogy of spring is a good one. It can really be a second shot at life. You can have somebody who was really quite limited and then all of a sudden they can go out, they can golf, they can shop, they don't need oxygen anymore. They can go to family events and live a life that without the transplant never would have been possible. What you do involves a lot of tough decision making and if somebody is a possible candidate, what are the things that you look at to make the determination? Are there cutoffs for age or smoking history or anything else? Well, there are. We, to make it as simple as possible, our group takes a very open mindset. We don't make arbitrary cutoffs due to age or other conditions. We take a whole look at the person and we ask, is this transplant likely to do you good? And if it is, then we give it real consideration. Is there a higher rate of rejections with lungs as opposed to kidneys, livers, other types of tissue? Absolutely. It's a tougher organ to manage immunologically. It's a large organ exposed to a lot of blood and you're breathing constantly so it's exposed to the outside environment. A kidney is not and unlike a kidney, for example, there's no dialysis for the lung. If it fails, you can't continue on. It was about a year ago that the University of Maryland Medical Center made national news with a heart transplant where the donor, if you would, was a pig. It was called Xeno transplantation and it worked for a period of time and some see it as the next frontier. What do you see ahead specifically when it comes to lungs? Xeno transplantation is really remarkable. It has always been kind of a joke in the transplant community that Xeno transplant is the future and it always will be. They say about nuclear fusion too. That's right. It's always two decades off. But here we are and I think we're starting to see the beginning of, I guess, the future and there are some remarkable steps being made, some historic steps being made in the direction of Xeno transplantation. I think that lung will be on the tail end of the advancements along those lines. It's just gonna be a little bit tougher organ to make that work but a lot of the things that we do today would have been inconceivable 200 years ago so someday we'll probably get there. We know people can donate a kidney. We get two of them. People can donate a piece of a liver amazingly. There's no live donation when it comes to lungs. Well, it's been done. You can give a lobe of a lung to a child and that's been done. Our center doesn't do that and we really focus on donors who donate after their life has passed. And some advice to keep all of our lungs healthy and stay out of your office. Don't smoke, exercise, don't breathe in anything other than good clean air. And the best place for people to find out if they haven't signed up as a donor and are thinking about it, where do you go? I think registerme.org is a good place to go and the DMV again is another good place to sign up but as important as signing up is having that conversation with your family because when you're not there to tell people what you wanted with your body after you died, it's important that the loved ones that you leave behind know your preferences. Dr. Robert Reed, Medical Director of the University of Maryland Lung Transplant Program. Doctor, we appreciate your time. Your health segments are a co-production of Maryland Public Television and the University of Maryland Medical System.