Lung Transplant - Information for Physicians

For increasing numbers of patients, lung transplantation remains the best solution for an advanced lung problem. The demand for lung transplantation reflects the inherent complexity of the many underlying pulmonary diseases and the related difficulty in creating effective medical and surgical alternatives (compared, for example, to recent new therapy options for advanced heart disease).

Referring physicians who have patients considering transplantation should be aware of current trends in lung transplantation in the U.S.—and how the Temple Lung Transplant Program is more prepared than ever to help your patients get a new start on a better life.

To schedule an appointment with a Temple Lung Center physician, click here or call 1-800-TEMPLE-MED (1-800-836-7536).

How Lung Transplantation Has Evolved

This highly specialized field of surgery has been steadily evolving:

  • Procurement and handling of delicate donated organs and the protocols for pre- and post-surgical patient support have improved based upon broadened collective experience and practice standardization.
  • Regimens for induction therapy and long-term immunosuppression after transplantation have become more sophisticated and effective.
  • A 2005 policy for lung allocation scoring that emphasizes a patient's severity of illness and likelihood of survival after transplantation rather than time on the waiting list has led to decreased wait times and smarter allocation—for example, more patients with idiopathic pulmonary fibrosis (IPF) receiving transplants faster.
  • Newer and less invasive methods of transplantation have been introduced.
  • These changes—plus the good news of increasing numbers of donated lungs—have led to steadily improving U.S. survival rates and lower death rates among waitlist patients.
  • Overall survival rates in the U.S. after lung transplantation are 83% at 1 year, 54% at 5 years, and 29% at 10 years. [Yusen. Am J Transplant 2010;10:1047-1068]  

The Temple Lung Transplant Program

Established in 1994, the Lung Transplant Program at Temple is one of the oldest and most experienced centers in the region. The Temple team has performed over 200 lung or heart/lung procedures and is certified by UNOS (United Network for Organ Sharing) for lung transplantation.

Outstanding Surgeons

This well-established program has kept pace with the newest opportunities for improved care in lung and heart-lung transplantation. Most recently, the Temple recruited Yoshiya Toyoda, MD, PhD, the internationally renowned transplant surgeon from the University of Pittsburgh, and Larry Kaiser, MD, the surgeon who established the well-regarded lung transplantation program at the University of Pennsylvania in 1991.

Dr. Toyoda, now Vice Chief of Cardiothoracic Surgery at Temple, pioneered the antero-axillary approach in lung transplantation, a new minimally invasive form of surgery that avoids many complications of the standard lung procedure. He has also performed and reported on many innovative combination surgical procedures to help patients avoid common complications (e.g., prophylactic tricuspid valve repair combined with double lung transplantation to prevent right ventricular failure; ablation to prevent atrial arrhythmias after lung transplantation). Along with Dr. Toyoda and Dr. Kaiser, the Temple surgical lung transplant team also includes Drs. T. Sloane Guy. These surgeons are 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.

A Fast-Moving Team, A Long-Term Commitment

Collaboration of the outstanding surgical team with the Division of Pulmonary Medicine has always factored in the success of the Temple Lung Transplant program. As one of the nation's leading referral centers for patients with severe forms of COPD, pulmonary fibrosis, pulmonary hypertension, sarcoidosis, and other serious lung disorders, the Temple Lung Center under the direction of Dr. Gerard Criner is a natural partner for the cardiothoracic surgery group. Together, they have built a multidisciplinary team of transplant specialists that includes: surgeons, clinicians, immunologists, psychologists, nurse specialists, technicians, counselors, nutritionists, and financial coordinators.

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.

Experience and Innovation at Every Step

The Temple team is highly experienced in all aspects of this complex and evolving procedure. For example:

  • Before the actual surgery, our clinicians fully evaluate the patient with specialized tests to ensure suitability and to determine the Lung Allocation Score.
  • Temple's expedited evaluation and listing process can prepare a patient for transplantation in as few as 24 hours.
  • Other clinician team members work aggressively to identify the potential donor lung(s) and then quickly and meticulously evaluate, harvest, and prepare that donated organ.
  • Temple pulmonologists can often boost the chances for finding a usable donor lung by performing a careful bronchoscopic evaluation of the potential donor lungs or by correcting problems with the lung (e.g., poor blood gas results) prior to harvesting.
  • After the procedure, the Temple ICU care is provided by a large dedicated team of clinicians and transplant-certified nurse practitioners.
  • During recovery, the Temple staff skillfully choreographs the many ventilation, medication, and rehabilitation protocols in a manner that maximizes the chances for a successful long-term outcome.
  • Recovery is a long-term medical partnership that extends well beyond the hospital stay. That's why we reach out to our physician colleagues about the proper course of ongoing care and the necessary post-transplantation follow-up visits of their referred patients.
  • Our research innovations continue to make life-saving treatment a reality for a much larger population of older and sicker patients.

At all stages, the Temple team communicates on a regular basis with the patient's referring and primary care clinicians as well as the patient’s 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 continues for the long term. Temple clinicians will maintain contact with transplanted patients for life—before, during, and after the procedure.

To schedule an appointment with a Temple Lung Center physician, click here or call 1-800-TEMPLE-MED (1-800-836-7536).