On March 22, Kelly Asbell had to be hospitalized again. She’s been in a hospital bed ever since.

One day earlier, the Valparaiso, Ind., mother of 10-year-old twins celebrated her 40th birthday — a milestone — by performing 40 acts of kindness for strangers. She delivered fresh tulips to a woman in a nursing home, dropped off coins at a laundromat, put quarters into candy machines, left toys on a playground and juice boxes at a day care center, among other gestures.

“I wasn’t expected to live past my teenage years,” she said.

At 10, she was told she had cystic fibrosis, an inherited life-endangering disorder that damages the lungs and digestive system. The average life expectancy for people with cystic fibrosis was 37.4 years in 2008, said the University of Rochester Medical School.

“When you have cystic fibrosis, you can’t take anything for granted, especially another year of life,” she said.

Within 24 hours, she was hospitalized yet again in her life for serious breathing problems. Her diseased lungs were suffocating her.

She spent the month of April gasping for air with medical assistance. Doctors determined that only a double lung transplant would save her life. On May 4, Asbell was placed on a transplant list. “JUST LISTED!” stated a handmade sign she held from her hospital bed.

She posted a photo on Facebook of herself. “Prayers needed,” she said.

There have been more than 38,000 lung transplants completed in the United States since 1988, according to the Organ Procurement and Transplantation Network. The one-year survival rate from such a procedure is 80 percent, though it drops to 50 percent at five years.

Long-term survival after a lung transplant is not as promising as it is for other organ transplants, such as a kidney or liver. Asbell has always known this.

One of her close friends, Alyssa Mathas, had her cystic fibrosis diagnosed when she was a baby. By 16, she needed a double lung transplant. In 2010, a healthy pair of lungs became available. Surgery was successful. Just months later, Mathas took part in a 5K race with Asbell.

Two years later, Mathas’ health plummeted again. She was airlifted to a St. Louis hospital with respiratory distress. Mathas died Jan. 23, 2013. She was 19.

“I want to see my twins graduate from high school in seven years,” Asbell said while waiting for her own double lung transplant.

Thirteen days after being placed on the list, at 8:11 p.m. on a Thursday, Asbell received a phone call.

“They asked if I was interested in two beautiful young lungs that seemed perfect for me,” Asbell said.

On May 18, she underwent a double lung transplant at Loyola University Medical Center in Chicago.

Hours passed. Her family waited. Finally, her transplant surgeon, Dr. Jeffrey Schwartz, informed Asbell’s family that everything went fine. He even showed them a photo of Asbell’s diseased lungs, saying they weighed 10 pounds, filled with bacteria and mucus.

Her husband, Scott, posted on Asbell’s Facebook page: “The woman known for Random Acts of Kindness was given the biggest gift of all — her life back.”

Asbell’s health slowly improved. She took her first deep breaths in years. She got out of her hospital bed. She slowly walked the halls. Six days after the surgery, Asbell was feeling “survivor grief” for the donor of her lungs.

“Though I don’t know this person, I’m working on learning to accept this gift with full open arms,” she said.

Each time she notices herself walking or talking without becoming breathless, she says, “My donor has such great lungs,” instead of saying “my lungs.” “I am so thankful to my donor. I’m not really accepting emotionally that they are mine. But I feel so blessed to be alive.”

Recently, Asbell and her husband celebrated their 12-year wedding anniversary. “Not too often we get to have a double lung transplant and a party in a hospital room,” Scott wrote on Facebook.

“I want to just live more in the moment without being worried about the next day,” she said.

And her next breath.