- Ex Vivo Lung Perfusion Helps Make More Lungs Available for Transplants
"Up to 20% of lungs that were otherwise deemed unusable can become usable by assessment in ex vivo lung perfusion." – Daniel Dilling, MD
Exceptional Outcomes for Lung Transplant Patients since 1988
Loyola Medicine offers the highest level of multidisciplinary, integrated care for advanced lung disease patients who may be considering a lung transplant. Loyola takes on the most complicated cases; so if you’ve been turned down by another transplant center, consider getting a second opinion at Loyola.
A lung transplant is surgery to remove one or both damaged or diseased lungs and replace them with healthy donor lungs. Preparation for a lung transplant is an extensive process and includes a detailed evaluation, a search for donor lungs, the transplant surgery and a recovery period.
Lung transplant surgery may be a life-saving treatment for individuals with end-stage lung failure or lung diseases such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, interstitial lung disease (ILD), LAM and pulmonary hypertension. It is an extensive surgery most often used when other medications and surgical procedures do not work to treat your condition.
At Loyola, you will have an entire team on your side, including your transplant pulmonologist, transplant surgeon, anesthesiologists, nurse coordinators, nurse practitioners, procurement nurses, radiologists, transplant chaplains, physical therapists, infectious disease specialists, dietitians, financial coordinators, clinical pharmacists, social workers and psychologists. We have one goal: restoring you to better health.
Why Choose Loyola for Lung Transplant Surgery?
A successful lung transplant starts the moment you walk in the door. We are thorough in our testing and complete in our patient education. We will leave no question unanswered. Your doctors, nurse coordinators and nutritionists will ensure that you are in the best possible state of health before surgery and prepared for the next chapter in your life.
Since Loyola’s lung transplant program started in 1988, we have performed more than 1,000 lung and heart-lung transplants. Our transplant pulmonologists and surgeons are widely regarded and highly experienced in treating the most challenging cases. In fact, Loyola is the only transplant center in the United States to perform five lung transplants in the span of a day, showing the dedication, drive and talent of our team.
Loyola’s lung transplant program is among the top 15 percent in the world with regard to volume, which leads to better outcomes. Our one-month and three-year patient survival rates, along with our one-month and three-year graft survival rates, are better than the national average. In addition, our infectious disease team ensures that the transferred tissue is as healthy as possible.
While you wait for a donor, you may face other health challenges related to your condition. Loyola’s subspecialists provide expertise in a wide range of health conditions, and your transplant team will facilitate a referral to an appropriate specialist if needed. Loyola participated in a clinical trial to increase the number of donor lungs suitable for transplant. This innovative technique is called ex vivo lung perfusion (EVLP).
Whether you need a heart-lung, double-lung or single-lung transplant, Loyola’s highly skilled transplant team will provide the most advanced care. As part of an academic medical center, Loyola’s doctors perform and teach the latest surgical techniques and medical practices. Our transplant team is often consulted by doctors at other hospitals because of their expertise and experience. We would welcome offering you a second opinion.
What are the Different Types of Lung Transplants?
Lung transplant patients can benefit from three kinds of transplants:
Single-lung transplant — One diseased or damaged lung is removed and replaced with a healthy donated lung. This surgery is beneficial for patients with pulmonary fibrosis, among other diseases. However, it is not used as a treatment for patients with cystic fibrosis, because the condition will spread from the diseased lung to the donated lung.
Double-lung transplant — Both damaged or diseased lungs are removed and replaced with a healthy set of donated lungs. This is considered the optimal treatment for patients with cystic fibrosis and chronic obstructive pulmonary disease (COPD).
Heart-lung transplant — The damaged or diseased heart and lungs are removed and replaced with a healthy donated heart and a set of lungs. This is often the recommended therapy for people with severe pulmonary hypertension.
With the goal of bringing life-saving lung transplant surgery to more patients, Loyola participated in a clinical trial to increase the number of donor lungs suitable for transplant. This innovative technique is called ex vivo lung perfusion (EVLP).
What Diseases are Treated with Lung Transplant?
Loyola’s pulmonologists and transplant surgeons are well-versed in every type of lung disease. Your healthcare team will first explore conservative treatments. If your condition is not well controlled with other method, a lung transplant may be the best medical option. Some lung conditions that may require a lung transplant include:
Evaluation and Wait List for Lung Transplants
If your Loyola pulmonologist recommends a lung transplant as the next step in your care, your healthcare team will confirm your diagnosis of end-stage lung disease and start your lung transplant evaluation.
The first step in your evaluation process will be to establish that you will be able to get to the Transplant Center within four hours of receiving the call that an organ or multiorgan donation is available. Next, your transplant team will guide you through the evaluation process. Your pulmonologist will take a detailed personal and medical history before conducting a physical examination. Several tests will be ordered to assess the status of your health. We will be there with you every step of the way, informing you of your test results and next steps.
The Medical Review Board will discuss your case and decide whether you are a good candidate for lung transplant. If so, you will be placed on the national waiting list with the United Network for Organ Sharing (UNOS). The wait time for deceased-donor organs depends on many factors, including medical urgency, compatibility to the donor and geography (organs are matched within the same region whenever possible). We encourage you to participate in our support group, which will help you manage this stressful waiting time.
Ongoing Treatment and Recovery after Lung Transplant Surgery
Once you are on the list for a heart-lung, single-lung or double-lung transplant, your Loyola team will make sure that you are up to date on all tests. We also will work with you on your exercise and dietary plans so that you are in the best possible condition once an organ match is available.
Once a match is confirmed, we will arrange the surgeries and start preparations. Your nurse coordinator will inform you and your family about where to go. Time is of the essence, and you will be expected to leave for the hospital shortly after receiving the call that a donor lung is available.
There will be several last-minute tests after your arrival at the hospital. Your surgery will take four hours or more, and then you will start your recovery. You will be closely monitored after surgery, and your nurses will be there to assess your pain and administer medication to make you comfortable. You will have a breathing tube and catheter as you recover from transplant surgery. Your nurses will ask you to do some deep breathing exercises and coughing to prevent complications. If needed, physical therapists will work with you to get you walking. Many lung transplant recipients go home after 15 days, but each patient’s case is unique.
You will be prescribed immunosuppression medications to prevent transplant rejection. Within the first day, you may notice the difference the transplant can make. Your nurse coordinator will map out your lab tests and doctor visits to assess the function of your new organs. You will have many appointments in the first year after surgery, but gradually your primary care doctor will start to take over your care. Complete recovery time varies from patient to patient, but most lung transplant patients are able to return to their studies or work after six months. Should you ever have a question, your Loyola transplant care team is available around the clock.
Pre- and Post-Lung Transplant Care in Your Community
Loyola understands that receiving care close to home makes life easier, which is why we provide care for patients with lung disease in four convenient locations:
- Center for Heart & Vascular Medicine in Maywood
- Loyola Hepatology Clinic – Mercy Medical at Dearborn Station
- Loyola Center for Health at Oakbrook Terrace
- Loyola Outpatient Center in Maywood
Services available at these centers vary and may include:
- Care for patients with pulmonary hypertension
- Care for recently discharged patients
- New patient, wait list and established patient visits
- Walk-in patients/sick visits
Ongoing Clinical Trials to Advance Lung Transplant Research
Loyola is conducting research today that will lead to the treatments of tomorrow. Our lung transplant program is the only one in the state of Illinois to receive funding from the National Institutes of Health for lung transplant research.
Loyola was one of six centers in the United States to participate in a clinical trial to increase the suitability of donor lungs. Ex vivo lung perfusion (EVLP) is an innovative technique that is applied before transplantation, infusing nutrients into the lungs and reducing swelling, making the organ more suitable for transplant. Loyola patients have access to other medications and therapies through our clinical trials.
We have many research programs underway, including clinical trials for idiopathic pulmonary fibrosis, LAM, cellular mechanisms in acute lung injury, Langerhans cell histiocytosis, Hermansky Pudlak syndrome, pulmonary hypertension, RSV in lung transplant patients, immunosuppression regimens in lung transplantation and the effect of donor alcohol use in the recipients of lung transplants. Loyola’s program also has created a biobank to assist with future research.