Lung Transplantation
Temple Expands Transplant Staff, Programs, and Research to Reach Difficult-to-Treat Patients
To meet the growing demand for better surgical solutions to advanced lung problems, Temple has made significant ongoing investments in its programs for lung and heart-lung transplantation. Today, the Temple program is one of the most active and truly multidisciplinary lung transplant centers in the U.S.
An Era of Change in Lung Transplantation
Temple Transplant Program Grows To Meet the Need
Lung and Heart-Lung Transplantation at Temple
A Fast-Moving Team, A Long-Term Commitment
An Era of Change in Lung Transplantation
Over the past decade, several factors have reshaped the highly specialized field of lung transplantation. While the surgical technique itself has evolved incrementally, the procurement and handling of delicate donated organs and the protocols for pre- and post-surgical patient support have greatly improved based upon broadened collective experience and practice standardization. The regimens for induction therapy and long-term immunosuppression after transplantation have become more sophisticated and effective.
A change in the diagnostic characteristics of patients receiving lung transplantation reflects a new policy for lung allocation instituted in 2005—a policy that emphasizes a patient’s severity of illness and likelihood of survival after transplantation rather than time on the waiting list. Overall, more patients with idiopathic pulmonary fibrosis (IPF) are now receiving transplants, a shift evident in recent statistics at Temple where 50% of newly waitlisted patients (July 2006 to June 2007) had IPF as their primary diagnosis1.
These changes—plus the good news of increasing numbers of donated lungs—have led to steadily improving U.S. survival rates, decreased wait times, and lower death rates among waitlist patients2. At the Temple Lung Center, patients with serious lung disease are getting access to—and benefiting from—the expanded range of advanced treatment options including transplantation.
The Lung Transplant Program at Temple has kept pace with these new opportunities for improved care. Most recently, it added a fourth highly trained cardiothoracic surgeon who specializes in lung and heart-lung transplantation. Temple has also steadily increased the capacity of all outpatient and inpatient programs for lung transplantation, significantly expanding all transplantation clinical staff, facilities, and related resources.
Established in 1994, the Lung Transplant Program at Temple is fully certified by UNOS (United Network for Organ Sharing). The program is the result of a long-standing collaboration between the Temple Lung Center and the Temple Department of Cardiothoracic Surgery. In recent years, this collaboration has blossomed. Over the past five years Temple cardiothoracic surgeons and pulmonologists performed 875 major lung operations or other procedures for complicated lung conditions3. According to the latest numbers submitted to UNOS, 35 lung transplants were performed at Temple in 2007. This current volume places Temple among the most active transplant centers in the U.S.—well above the reported average (23) and median (16) annual volumes for the 60 lung transplant centers active in the U.S. during 20062.
The Temple lung transplant team is highly experienced in all aspects of transplantation medicine—in performing the surgery, in improving and maintaining the health of patients waiting for surgery and in managing the detail-intensive post-transplant care and long-term follow-up care that are so critical for long-term success. An aggressive and inclusive philosophy is a distinguishing feature of Temple’s program. Many patients who are considered too ill or unstable for transplantation at other institutions are accepted for evaluation and treatment at Temple. In fact, Temple’s recognized strengths in caring for the most acutely ill pulmonary patients have translated directly into very tangible benefits for their patients at all stages of advanced lung disease and transplantation care.
Our lung transplant team consists of surgeons, clinicians, immunologists, psychologists, nurse specialists, pulmonary technologists, social workers, nutritionists, and financial coordinators. Our cardiothoracic surgeons are board-certified in both general surgery and cardiothoracic surgery and they are all experienced in lung transplantation techniques.
Temple's expedited evalutation and listing process can prepare a patient for transplantation in as few as 24 hours.
Our transplant physicians work 24/7 to identify potential donor lung(s) and then quickly and meticulously evaluate, harvest, and prepare donated organs. We optimize potential donor organs using bronchoscopic and ventilator techniques maximizing the chance of successful donation and implantation.
Post-transplantation ICU care is provided by a multidisciplinary team comprised of transplant pulmonologists, cardiothoracic surgeons, fellows, certified nurse practitioners, pharmacists and nutritionists. During recovery, the Temple team skillfully choreographs the many respiratory, medical, and rehabilitation protocols in a manner that maximizes the chances for a successful long-term outcome. Under the direction of the transplant pulmonologist, the staff helps the patient recover from surgery and transition toward independent living.
Recovery, of course, is a long-term medical partnership that extends well beyond the hospital stay. That’s why we reach out to our physician collegues about the proper course of ongoing care and the necessary post-transplantation follow-up visits of their individual referred patients.
At all stages, the Temple team communicates regularly with the the patient’s referring physician and family members. This personalized service is built around a firm commitment to patient- and family-centered systems of care. As is the case with so many of the chronically ill patients referred to Temple, this commitment to service continues for the long term. Temple clinicians will maintain contact with transplanted patients for life—before, during, and after the procedure.
References
1 Scientific Registry of Transplant Recipients, Program Specific and OPO Reports January 2008
2 OPTN/SRTR 2006 Annual Report; VI. Heart and Lung Transplantations
3 Pennsylvania Health Care Cost Containment Council (PHC4) 2006 Hospital Performance Report (2007)
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