By Dave Ingram
The Chronicle ( Duke U. )
(U-WIRE) DURHAM, N.C. -- Challenging conventional criteria for the
selection of transplant recipients, Medical Center researchers reported
this week that patients who undergo heart procedures are as likely to have
successful lung transplants as other patients.
The report is the first major study to look at patients who, directly
before receiving a lung transplant, also had a significant heart
revascularization -- such as a coronary bypass operation. Researchers found
that those patients recover as quickly and as well as other transplant
recipients, possibly opening the door for some people whom doctors
previously considered higher-risk applicants.
Applicants for any organ transplant must meet certain criteria, mainly
potential for long-term survival, before they are eligible.
"In certain patients with coronary disease, if you [perform
revascularization on them], their survival rate is fairly to close to what
would be expected for other patients," said Dr. R. Duane Davis, associate
professor of thoracic surgery and one of the researchers who conducted the
study. "We felt that, in those situations, there would be very little added
risk from the coronaries."
The study examined 350 lung transplants at Duke University -- the
largest performer of lung transplants in the country. Of those, 12 patients
underwent bypass surgery, and six had an angioplasty procedure just before
the transplant. Their survival rate was about 88 percent, while about 81
percent of other transplant recipients survived.
Dr. Vijay Patel, a clinical associate in thoracic surgery, presented the
study results Monday to the 98th annual conference of the American Thoracic
Society.
He noted that patients receiving coronary operations did not require a
delay in their transplant because doctors can usually perform the first
procedure while waiting for a transplant organ to arrive.
"We have shown that we can improve the quality of life of these patients
without increasing the amount of time the patient is on the table," Patel
said in a statement. "Also, their length of stay in the hospital was
similar to those transplant patients who didn't get the
revascularization."
Davis also said that many patients with cardiac problems have difficulty
getting coverage for transplants from insurance companies, something he
said the study may help change.
However, Duke is still one of very few medical centers that regularly
combines the operations, Davis added.
He expressed hope that others would follow suit, but he noted that only
a select few patients are eligible. Patients who have other heart problems
or additional complications may have less success, he said.
(C) 2002 The Chronicle via
U-WIRE
