Lung Transplant

Studies conducted at the Center for Advanced Lung Disease and Lung Transplantation continue to improve treatment options, prevent or delay the progression of serious lung diseases, and improve the quality of life and survival for our patients. Those who undergo lung transplantation benefit from our clinical and academic expertise and our commitment to improving outcomes through:

• Personalized care. Our patients receive the latest and most effective therapies individualized to their case and clinical status, reducing the risk of rejection, infection and other complications improving their outcomes. Our physicians advance lung transplantation further by investigating new immunosuppressant medications and exploring novel drug combinations to increase the longevity of the transplanted organ while decreasing the side effects associated with this treatment.
• Care of sicker patients. Expertise in our preoperative management and life support has allowed our Program to transplant much sicker patients with significantly higher lung allocation scores compared to the rest of the country.
• Less need for heart-lung bypass. Most transplant surgeries are now performed without using the heart-lung bypass machine, sparing patients from associated postoperative complications. Instead, when additional support is needed, extracorporeal membrane oxygenator (ECMO) is typically used during surgery.
• Smaller incisions. Surgical refinements have reduced the size of the incision required during transplantation.

The survival rates for our lung transplant recipients have soared far above the national average. Since the inception of the new transplant team in 2001, we have performed more than 1,500 operations with the one-year patient survival at 89 percent and three-year patient survival at 83 percent, which is statistically better than expected for three-year graft survival. The average wait time for a lung transplant “is” six and a half months,, with one in four patients receiving a transplant within 45 days of being placed on the Lung Transplant Wait List.

Because so many donor lungs are damaged at the time of death, less than 20 percent are viable for transplantation. NewYork-Presbyterian/Columbia doctors participated in a pivotal clinical trial showing the effectiveness of a novel technique called "ex vivo lung perfusion" (EVLP). By evaluating and preparing donor lungs outside the body before transplant surgery, EVLP could significantly increase the available pool of donated lungs by reconditioning donor lungs that have sustained damage making them suitable for transplantation.

The lungs are warmed to normal body temperature, flushed of donor blood, inflammatory cells, and potentially harmful biologic factors, and treated with antibiotics and anti-inflammatory agents. In some cases, lungs that might have previously been deemed unsatisfactory for transplantation can be successfully replenished and repaired with EVLP, rendering them usable. The first ex vivo lung transplantation at NewYork-Presbyterian/Columbia was performed in 2011, saving the life of a 59-year-old woman.

Some patients with severe lung disease can be supported with ambulatory extracorporeal membrane oxygenation (ECMO) — a way to artificially oxygenate the blood—at NewYork-Presbyterian/Columbia while waiting for a lung transplant. Our ECMO Program has been designated a Platinum Level Center of Excellence for the Excellence in Life Support Award from the Extracorporeal Life Support Organization, an international non-profit consortium dedicated to the development of novel therapies for people with severe lung failure who require mechanical support.

Transplantation is a life-altering procedure. Patients need life-long immunosuppressant medications and very careful monitoring indefinitely. Throughout the transplant process and beyond, we partner closely with recipients and referring physicians to achieve a seamless continuum of care, while helping patients and their families navigate any emotional, financial, and logistical concerns they may have. Our transplant team is here for the patients — for life.