Norway's Crown Princess Mette-Marit will likely need a lung transplant as her health has worsened in recent months, the country's royal household has said.
The princess, 52, was diagnosed with pulmonary fibrosis in 2018. The degenerative disease creates scar tissue that stiffens the lungs making it difficult to breathe and for oxygen to enter the bloodstream.
Tests in autumn showed a clear worsening of her health, the palace said on Friday. We are reaching the point where a lung transplant will be necessary, Are Martin Holm, head of respiratory medicine at Oslo University Hospital, said.
Princess Mette-Marit told public broadcaster NRK that her illness had developed faster than I'd hoped.
No decision has been taken yet on whether she will be placed on the transplant waiting list, Dr Holm said. The palace said her doctors had started the process towards an evaluation for lung transplant surgery.
In Norway, there are usually between 20 and 40 patients on the waiting list for a lung transplant and Princess Mette-Marit will not be given preferential treatment if she is placed on the list, local media reports.
Although she is not yet on a donor list, Dr Holm said her healthcare team was undertaking the necessary preparations to ensure that [a transplant] will be possible when the time comes.
The palace said Princess Mette-Marit had an increasing need for rest and a targeted exercise regimen.
However, she had expressed a strong interest in continuing to carry out her duties, it added in a statement on Friday. Her royal duties and engagements will be adapted to her ongoing health issues.
Holm described pulmonary fibrosis to reporters as a dangerous disease that often could not be seen because it depended on how sick an individual was.
At rest, they might be able to breathe normally, Holm explained, but when they exert themselves - through exercise, for example - their lungs can no longer keep up.
Princess Mette-Marit's husband, Prince Haakon, Norway's future king, sat beside her for an interview with NRK, in which he explained that she may appear perfectly fine when sitting still, but said he had noticed her struggling more with breathing.
He also said she had less energy and was getting ill more often.
Hiking or skiing together - activities the pair enjoy - were no longer possible, the crown prince added.
The thought of the transplant alone had been demanding, Mette-Marit said, as she knew it will involve risks.
A successful transplant hinges on several factors, including finding the right match and ensuring the body does not reject the new organ.
Transplant is seen as a last resort, Dr Holm explained, telling reporters that individuals must be significantly ill and have a limited life expectancy before a lung transplant can be deemed appropriate.
News of the princess' deteriorating health comes months after her eldest son was charged with 32 offences, including four counts of rape. Marius Borg Høiby, 28, denies the most serious accusations against him, but plans to plead guilty to some lesser charges when the trial begins, his lawyer Petar Sekulic told news agency Reuters in August.
Mr Høiby is the stepson of the heir to the Norwegian throne, but does not have any royal title or official duties.
