Fernando Torres, M.D. Answers Questions On: Lung Transplants

When a patient is referred for evaluation for lung transplantation, we must take a very close look to make sure that it would be safe for the patient to undergo a transplant. A multidisciplinary team of doctors and other experts help make that decision.

Once we have completed the evaluation process – looking not only at clinical information, but also psychosocial factors – we are able to formally present the patient to the transplant committee.

The transplant committee is made up of doctors, surgeons, dietitians, social workers, and other medical personnel who work together to make sure that it is appropriate for a patient to be placed on the active waiting list.

Once the committee approves a patient, we must wait to receive an organ offer. When an offer is made by the organ procurement agency, the surgeons will evaluate the donor organ. At that time, the patient will be brought to the hospital and cleared for surgery. While the surgeons are acquiring the donor organ, the patient receiving the new lung will start his or her own surgery, resulting in the implantation of the new organ.

Once the operation is complete and the patient is able to move out of the intensive care unit, the transplant pulmonology physician team collaborates with the surgeons to medically manage the patient.

Most people probably expect that it will take them many months to regain their strength and recuperate from surgery. But actually, patients who undergo lung transplantation can expect to be in the intensive care unit for about four days, with another seven days in the hospital. By day 10 to 14, they typically can be discharged home without needing any oxygen.

Once they have been discharged home, they are able to start outpatient rehabilitation. Generally, at about two months they are able to walk at a brisk pace and are able to do day-to-day activities without any difficulty. By six months, they are able to do whatever they want – without the need of supplemental oxygen. 

Some people believe that your life expectancy is very, very short after a lung transplant, but actually the average life expectancy after lung transplantation is about six years.

Current statistics show that about 50 percent of patients are alive at six years, but many others live up to 20 years after the transplant.

UT Southwestern is a world-class medical center that participates in multicenter clinical trials to learn about lung disease and improve the survival of our patients.

One such clinical trial we will be starting involves using new technology to improve the viability of donor organs. This technology would allow us to increase the number of donor organs available to help our patients.

UT Southwestern has also added advanced equipment to help keep patients alive while they are extremely sick. In the past, when a patient with advanced lung disease deteriorated, they would be put on a ventilator and kept alive on a breathing machine. However, if other organs, such as the heart, were compromised, suddenly you would not be able to keep them alive.

We now have newer equipment available that allows us to ambulate and exercise patients while on life-sustaining machines. This enables us to preserve their strength and muscle mass, which helps to make lung transplant more of a viable option.

I think what distinguishes us from other programs is that we have experts in every field supporting the lung transplant program.

Our program is multidisciplinary, where we depend on other services to help us manage our patients. The multidisciplinary team includes not only surgeons and pulmonologists, but also cardiologists, nephrologists, dietitians, respiratory therapists, and nurses, among many others.

Each member of the team brings their expertise to think in synchrony on the best treatment plan for our patients. We have multiple meetings and conferences that allow the physicians to share ideas and opinions on how to help the patients, thus making this a real multidisciplinary program.