Pulmonary Organ Transplant – Mayo Clinic

Today’s podcast featured Dr. PJ Spencer discussing lung transplantation. Dr. Spencer highlighted the increasing number of transplants being performed, with a shift towards older and sicker patients, especially those with pulmonary fibrosis. He discussed the criteria for eligibility, the use of ECMO in surgery, and the challenges of long-term survival due to immunosuppression and risk of rejection. Dr. Spencer also touched on areas for improvement in transplant procedures, including managing donor organ infections and developing treatments for chronic rejection. Overall, the podcast provided valuable insights into the field of lung transplantation, with a focus on enhancing patient outcomes and longevity.

In the realm of lung transplantation, Dr. PJ Spencer sheds light on the evolution of this life-saving procedure. Initially developed in the early 1980s, lung transplantation has significantly progressed, with advances in technology and a decline in smoking rates reshaping the patient population. While COPD and emphysema were predominant indications initially, conditions like pulmonary fibrosis now account for over 30% of lung transplants. Moreover, the age range of recipients has expanded, with individuals in their 70s now eligible for the procedure.

Dr. Spencer elaborates on the criteria for selecting candidates, emphasizing the importance of a six-month cessation of smoking to ensure optimal outcomes for the new lungs. With the rise in organ donations, aided in part by increased awareness and unfortunately, the opioid crisis, more patients in dire need are receiving transplants. The use of Veno-venous ECMO intraoperatively has become instrumental in managing severe pulmonary hypertension, enabling safer, more successful surgeries, especially in older and frailer patients.

Looking ahead, the focus lies on improving donor organ quality, addressing chronic rejection, and optimizing surgical techniques. Research efforts aim to enhance long-term survival rates and refine treatment protocols, particularly in managing infections and chronic rejection post-transplant. Dr. Spencer’s insights underscore the continuous evolution in lung transplantation, offering hope to patients grappling with end-stage lung diseases and paving the way for further advancements in the field.


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