Perspective Eliminate The Deficit For Lung Transplantation – Part 1 of 3
Perspective Eliminate The Deficit For Lung Transplantation. A shift in medical procedures could greatly reduce and possibly eliminate the shortage of lungs available for transplant, US experts and an Italian swat suggest. The procedure – carefully controlling the volume of air and pressure inside the lungs of brain-dead patients on ventilators – nearly doubled the crowd of lungs that were able to be transplanted to save the lives of others, the study found. The United States has a shortage of lungs, as well as other organs, available for donation. People needing a lung transfer wait an average of more than three years, according to the United Network for Organ Sharing (UNOS). In 2009, 2234 people were added to the waiting list, according to the Organ Procurement and Transplantation Network (OPTN).
One vindication for the shortage is that lungs are “finicky” and easily damaged while comatose patients are on ventilators, said Dr Phillip Camp, director of the lung transplant program at Brigham and Women’s Hospital in Boston and chairman of the UNOS-OPTN operations and protection committee. But more carefully controlling how much air is pushed into the lungs by ventilators and maintaining pressure inside the lungs during such procedures as apnea tests, to stay breathing, improves lung viability dramatically, according to the study.
And “They found remarkable increases in the availability of viable lungs using this lung preservation strategy,” said Dr Mark S Roberts, chairman of the form policy and management department at the University of Pittsburgh and author of an editorial accompanying publication of the study in the Dec 15, 2010 issue of the Journal of the American Medical Association. The contemplation involved 118 brain-dead patients with otherwise normal lung function.
One group was given conventional ventilation, including relatively high volumes of air pumped in from the ventilator and disconnection of the ventilator during apnea tests, allowing the lungs to deflate. The others were given misdesignated “protective” ventilation. That procedure included less air volume, higher “positive end-expiratory insist upon levels,” which meant increasing the air pressure in the lungs near the end of expiration to maintain pressure, and the use of continuous positive airway pressure during various medical procedures and tests, which does not allow the lungs to entirely deflate.