Sometimes patients suffer with lung diseases that don’t respond to treatment. In those instances, a lung transplant could be the only way to extend their lifespan and improve their quality of life. The lung transplant procedure is especially common in patients with end-stage lung disease.
Although it is a risky surgery, advancements in pre- and post-transplant procedures have improved patient outcomes. Here are two examples of recent findings that could lead to further improvements.
EVLP Can Expand the Donor Pool
Ex vivo lung perfusion (EVLP) is an innovative therapy that is applied to lungs outside of the body before transplantation. Within the past decade, the treatment has been used to improve the quality of organs so they can become suitable for transplant. It also allows more time to assess if the lungs have persistent dysfunction, which minimizes the chance of transplanting organs that can’t function properly.
A study published in 2018 revealed that an acellular normothermic EVLP technique could reduce cell-specific leukocyte gene expression over a 12-hour period. The technique also identified potential biomarkers that could improve the process for selecting lungs on EVLP. This process would select lungs that are suitable to be transplanted and predict the risk of primary graft dysfunction, a serious complication. Although further research is needed to validate these findings, the technique could identify marginal lungs that would be viable for transplant while simultaneously eliminating potential donor lungs that aren’t suitable.
Drug Combination May Minimize Chronic Rejection
Patients are at the highest risk for life-threatening complications within the first year of undergoing a lung transplant. High risk patients are required to take medications for the rest of their life to suppress the immune system and help prevent the body from rejecting the new lungs. Even with standard precautions and medical treatment, the median survival rate after lung transplant is less than six years. The most common causes of death are chronic rejection, infection and cancer.
In August 2019, researchers at the University of Maryland School of Medicine conducted a study that analyzed a database of over 9,000 lung transplants. Their research led to the identification of a drug combination that appears to significantly extend patient survival. The combination of tacrolimus, an immunosuppressant, and sirolimus, a cell cycle inhibitor, was associated with a better median survival than the current standard treatment.
While every patient’s treatment and recovery are unique, the findings of this study could make a difference in outcome for lung transplant patients in the future.