Optimizing Lung Transplant Eligibility and Outcomes ... Before Surgery
Researchers at Mayo Clinic have identified ways to make more patients eligible for lung transplant and improve their outcomes after surgery.
Qualifying for lung transplant
Annually, nearly 2,700 patients age 12+ are added to the national waiting list for a lung transplant. To qualify for transplant, patients must meet a number of qualifications. Some qualification factors can't be changed, such as age. Others can be changed or improved:
- Untreated mental health condition
- Absence of a reliable social support system
- Substance addiction
- Severe obesity
Comprehensive care to address risks
Surrounding patients with multidisciplinary care for all aspects of their well-being can make more patients eligible to receive a lung transplant and improve their outcomes after surgery.
Specialized care for lung conditions including
- Pulmonary fibrosis
- Cystic fibrosis
- Pulmonary hypertension
Care to address complicating factors
- Pulmonary therapists: To maintain condition
- Registered dietitians: For healthy weight
- Physical therapists: Improve strength
- Social workers: Aid in self-care
- Psychiatrists: To address emotional strain
Healthier patients, better outcomes
The conditions that lead to lung transplants make it challenging to maintain health. But patients who can do so have an advantage.
- Frailty increases the likelihood of developing medical problems such as needing an emergency room, hospital or nursing home. Frailty makes recovery difficult and can even lead to death.
- Patients who undergo lung transplants who are not frail have better outcomes.
1-year survival rate for lung transplant recipients
- Overweight or obese patients who reduced their risk of death.
- Overweight and obese patients who decreased their BMI by 1-unit (on average 5-8 pounds) prior to transplant reduced their risk of death by 15%.
- Patients who reduced their BMI before transplant also spent fewer days on mechanical respirators and in intensive care after surgery.
- Patients with higher muscle for their body size had a survival rate that was almost 4x higher than patients with muscle index in the lower 25th percentile.
- Higher muscle was also associated with shorter hospital stays following lung transplant surgery.
Sources: MayoClinic.org; Ncbi.Nlm.Nih.gov (PMID: 25578626; 26701203; 26679297).