Innovations in Lung Transplantation

Specialized multidisciplinary programs are able to provide alternatives to transplantation for many patients as well as help treat other important medical problems that develop or co-exist in patients with advanced lung disease. Some examples include pulmonary hypertension and right heart failure, coronary artery disease, osteoporosis, and malnutrition.

Those who do undergo lung transplantation benefit from the breadth and depth of the program's clinical and academic expertise and its commitment to improved outcomes:

  • Surgical refinements have reduced the size of the incision required during transplantation.
  • Recent progress in anesthesia, surgical techniques and postoperative care have dramatically shortened the time patients spend in the hospital-an average of 12 to 14 days, down from an average of 20 days.
  • Most transplant surgeries are now performed without using the heart-lung bypass machine, sparing patients from associated postoperative complications.
  • The risk of postoperative rejection is minimized with the newest, most advanced anti-rejection regimens.

Surgery

Patients at the NewYork-Presbyterian Center for Lung Disease and Transplantation at Columbia University Medical Center benefit from numerous advances in surgery. For example, surgical refinements have reduced the size of the incision required during transplantation. Recent progress in anesthesia, surgical techniques and post-operative care have dramatically shortened the time patients spend in the hospital — an average of 12 to 14 days, down from an average of 20 days.

Throughout the surgery, a heart-lung bypass machine is on standby in case it becomes necessary to use this equipment to temporarily take over the work of the heart and lungs by pumping and oxygenating the blood. However, because of surgical and anesthesia innovations, most of the Program's lung transplant patients do not require the assistance of the by-pass machine, thereby reducing certain potential post-operative complications.

Double Lung Transplant in child with cystic fibrosis

Please note: this links to video footage from an actual operation. Discretion advised.

Medications

The Lung Transplant Program has also been in the vanguard of improving postoperative care by addressing the most significant risks to lung transplantation patients — rejection of the new "foreign" donor organ(s) and infections. Patients receive the newest and most effective anti-rejection drugs (immunosuppressants) and powerful antibiotic regimens.

Through their scientific and clinical research and participation in multi-center clinical trials, the Center's physicians contribute to the advancement of lung transplantation by investigating new immunosuppressive drugs and exploring possible drug combinations to increase the longevity of the transplanted organ while decreasing side effects associated with therapy. Therapeutic regimens to prevent and treat infections are also being used and studied.

NewYork-Presbyterian researchers have recently discovered the role played by a pair of protein receptors in the immune system's ability to develop tolerance to a new organ. Their work is part of an ongoing investigation into why and how transplanted organs are rejected by the body so that new and improved methods for protecting a transplanted lung can evolve.

New immunological surveillance techniques are now being developed at Columbia to enable the diagnosis of more subtle forms of rejection earlier than ever before, which ultimately could improve a lung transplant patient's quality and length of life. The researchers are also investigating methods for preserving donor lungs for a longer period of time before they must be transplanted into the recipient. Additionally, lung transplant program clinical investigators are focusing on identifying specific factors in patients that may help determine the optimal timing of transplantation.