Why do I need one?
If you need one, it is because you have an incurable respiratory disease that is treatable by a lung transplant. It can be one of many diseases, either inherited or acquired. Examples are emphysema, cystic fibrosis, pulmonary fibrosis, Alpha I, Primary Pulmonary Hypertension, BAC, IPF, etc.
This issue is probably the single most difficult one a patient can face early on in the terminal disease experience, if you will. Amidst all the shock of learning that you have a disease that will not be getting better, now you must decide if you want to pursue what many fear is a risky, painful, debilitating operation that, if it doesn't bankrupt you, will surely diminish your quality of life such that after getting it, living won't be any better than it would have been without it. This is completely false. Most of these assumptions are based in fear of something new, as lung transplants are virtually unknown to the general public and what little information there is has at times portrayed it in an uncomplimentary light. Why that is has probably more to do with the state of the art as it existed in the mid-to-late 80's than it does with the reality of lung transplantation as it currently exists, some 15 or more years later.
The fact is, lung transplantation is as successful a procedure as other mid-body whole-organ transplants for one-year, two-year, and often five-year intervals. Yes, over the longer term, lung transplantation can be less successful than other types of transplantation, but the question is, what would you do to get another six-to-ten years of life? And perhaps more to the point, what wouldn't you do? There are lung transplantees with over ten years of extra life walking around--does that appeal to you? Be advised that there are two factors working in the favor of the successful candidate--pharmaceutical advances that are both reducing the prevalence of Bronchiolitis Obliterans over time and improving the body's response to anti-rejection drugs, and the fact that lung transplants have only been considered a viable treatment for perhaps 15 years. I always say, hang in there until Medicine catches up to what you have and you might just have a chance.
In addition, there are ways to get the funds necessary for the transplant and the drugs required after it such as Medicare, Medicaid, and other plans that the yet-to-be disabled patient may not be aware, so discarding a chance at life based on finance looks more like an excuse than a real objection. The same goes for issues such as support and access--if you were told that moving your residence for two months would allow you to live another ten years or more, what would you do? Refuse?
Another way to pose the question at the top of this page is, of course, "what will happen if I don't get one?", or "can I get along without it?". (I cover this question in more depth elsewhere on this site.) Usually this is accompanied by fear of the operation, or denial of the condition that has made a transplant necessary. In truth, the ability to receive a transplant is a blessing, since many are afflicted at an age or are of a condition that makes a transplant impossible. The simple ability to ask "why?" is a privilege available to few. Sadly, even fewer can take advantage of it as long as the present donor organ shortage continues.
What will happen if you don't get a transplant? You will continue to deteriorate and eventually reach the end-stage phase of your disease, followed by death. We all die, some before others. Unfortunately, it is not as simple as that when dealing with a respiratory illness. The endstage of a respiratory disease is as unmanageable and difficult to endure as any of the famously debilitating diseases such as AIDS, Cancer, and the like. What is even more disheartening is that it is far more difficult for the family of a patient with endstage respiratory disease than for the patient. For their benefit alone, if a transplant is an option, that option should be exercised.
If you are able to ask why, then you are typically under 65 years of age, not grossly overweight, well adjusted mentally, of sound health except for the disease that has brought you here, and (generally speaking) insured.
If you are asking why not, then you are still in need of additional information.