faq

When was the first successful lung transplant performed?

The first successful single lung transplant was performed at Toronto General Hospital on November 7, 1983 by Dr. Joel Cooper. The patient was Tom Hall, a 59-year-old hardware store owner. Hall lived for six years after the transplant. Prior to the surgery, 44 lung transplants had been attempted, dating back to the 1960’s. All failed. The first successful double lung transplant was performed in 1986, also by Dr. Cooper at Toronto General.

Why did you get a single lung this time?

There is not a consensus in the transplant community on the question of whether to retransplant with a single-lung or double-lung. The main reason to retransplant with a single-lung is that there is a donor lung shortage and people are dying on the transplant waiting list. (Makes complete sense to me.) In some cases, a double-lung is called for because of the danger of cross-infection.

There are other reasons to retransplant with a single lung. Lung retransplant surgeries are generally more difficult than original transplants. This is because transplanted lungs can adhere to the chest cavity and can be more difficult to remove. Also, scar tissue can make retransplant surgery more time-consuming and difficult. Nevertheless, some transplant centers prefer to do double-lung retransplants. Less than 500 lung retransplants have been done according to UNOS data, as compared with 15,000+ original transplants. The bottom line is that while lung transplantation is a young science, lung retransplantation is an even younger one. At this point, nobody knows which type of retransplant is best.

What is the biggest problem for transplant patients?

Treating rejection.

How is rejection treated?

Rejection is treated in stages. The first stage is a “steroid blast” with IV Solumedrol, three doses over three days. The docs will do this a few times before they go to the second stage. The second stage was described well in a Second Wind newsletter: “[W]hen more aggressive intervention is warranted because lung function is declining rapidly or substantially, cytolytic therapy is often instituted. This consists of horse or rabbit derived antibodies directed against human lymphocytes, the immune cells that are thought to be paramount in orchestrating rejection. Cytolytic therapy is given in the hospital as a daily infusion over five to seven days.” I’ve had both the horse and rabbit versions of this stuff. If this does not work, they go to stage three.