A four-year-old boy from Co Meath needs $1 million for a life-saving lung transplant in the US.

Little Cian McDonnell, from Carlanstown, near Kells, Co Meath, is in Boston Children's Hospital tonight with his mum Lisa where he is due to undergo a five-day assessment next week to see if he's suitable for the operation.

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His dad Donal and big sister Chloe (14), their extended family and many friends are hopeful that doctors will perform the transplant on Cian.

If doctors give their approval, $1m will be required as Cian just has months to live and must undergo the transplant as soon as possible.

Shortly after his birth, Cian was diagnosed with a rare condition called Dyskeratosis Congenita and went blind before his first brithday.

Shortly afterwards, doctors treating Cian noticed his blood marrow was failing.

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He underwent a bone marrow transplant in January 2013.

"Basically after that, he was thriving. He was doing really well," family friend and fundraiser Mandy Shipp told independent.ie.

"But then in January of this year, he was becoming very short of breath and was in hospital for five weeks.

"It took the doctors a while to diagnose the problem and they had to do loads of tests.

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"He was eventually diagnosed with microscopic pulmonary avms, which is basically tiny pinholes in his lungs," Mandy explained.

"When he takes a breath in, the oxygen is going out through these tiny little pinholes, and he's not getting the proper level of oxygen."

An average person with fully operational lungs will get 95 to 100 percent of the oxygen they breathe in. Cian gets just 52pc - and this number is falling.

Doctors are not sure if this condition is linked to his previous condition.

When Cian was diagnosed in February, doctors at Our Lady's Hospital for Sick Children in Crumlin immediately referred him to Great Ormond Street Hospital in the UK which specialises in lung transplants.

"They carried out assessments in July - he underwent a three day assessment.

"But then they told his parents they wouldn't consider him for the donor lists.

"Boston Children's Hospital is his last hope," Mandy explained.

Cian has been at the hospital in Boston before. Doctors conducted a series of tests on him due to Dyskeratosis Congenita as they had never seen a child "thrive" with the condition as Cian had been doing. Cian went to the hospital in 2013 after his successful bone marrow transplant.

They are the world experts in Dyskeratosis Congenita and they are now going to assess him for a lung transplant - such tests have set the family back some $50,000.

Cian's family and supporters were prepared for news that the lung transplant would cost $500,000.

However, this week, mum Lisa received word it would cost $1 million - and this would not include costs for pre-care and post-care treatments.

The family are very hopeful that surgeons in Boston will accept Cian on to their waiting list, and feel he has a strong chance given their knowledge of his existing condition.

However, the funding for the operation is vital.

"We're desperate at this stage - if he doesn't get the lung transplant he won't live to see Christmas. That's a very real possibility and not an exaggeration," Mandy said.

"In May, he was given months to live and he has deteriorated.

"He's a lovely little fella - it's hard to believe that internally he's so ill. He's funny, wants to play, and he hates having his oxygen mask on. He loves Peppa Pig, and he was able to go to pre-school - he was able to do things that kids can do.

"But you can see that he is sick. He has bad days, and those bad days are getting more frequent," she added.

The community of Carlanstown and surrounding areas have hosted an array of fundraising activities for Cian in the last few months and the support has been huge - however, supporters they need every bit of help they can get to save the little boy's life.

Cian's supporters have set up a gofundme page at http://www.gofundme.com/hopeforcian and their Facebook page can be accessed at https://www.facebook.com/hopeforcian

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