Our ProgramThe USC Lung Transplant Program is a world-recognized leader and innovator in heart, heart-lung, and lung transplantation and cardiothoracic surgery. The team is composed of experts in their respective fields of cardiothoracic surgery, cardiology, pulmonary medicine, immunology, critical care medicine, cystic fibrosis, immunosuppression and rehabilitation. Anthem has designated our program as a Center of Medical Excellence, and Keck Hospital of USC is certified for Medicare for lung transplantation.
Pulmonary (lung) transplantation has become a viable treatment option for patients with end-stage cardiopulmonary disease. Patients eligible for pulmonary transplantation include any person who is severely debilitated by cardiopulmonary disease and is not hampered by any other organ system dysfunction. Candidates frequently have the diagnosis of obstructive lung disease, such as:
- Cystic Fibrosis
- Pulmonary fibrosis (e.g. sarcoidosis, IPF, silicosis)
- Pulmonary hypertension (both primary and secondary)
Restrictions to transplantation include:
- Active neoplastic disease
- Inability to comply with a strict medical regimen
- Lack of adequate support systems
- Severe obesity
- Systemic or untreatable local infection
- Tobacco or drug dependency
- Patients on chronic mechanical ventilation will be considered on a case-by-case basis.
Living-related lobar transplantation was pioneered at Keck Hospital of USC and provides an alternative therapy for severely ill patients who are unlikely to survive often long waiting periods for donated organs to be available. Strict criteria must be met before a patient can qualify for these living-related procedures.
Living-related donors are typically friends or family members of the patient, with two donors each donating a portion of lung to the recipient. Donor lobectomies for living-related lobar transplantation require a thorough evaluation of potential donors, as well as modification of standard lobectomy and pulmonary preservation techniques.
Our comprehensive program includes constant transplant team communication with patient/family regarding all aspects of medical care.
Becoming a Donor
After appropriate donors are identified, one donor is selected for right lower lobectomy and the other for left lower lobectomy. In our experience, donors typically do well after surgery – walking 24 to 48 hours after the operation and discharged in one to two weeks. The long-term effects for donors are minimal to none.
Bronchiectasis is caused by a reoccurring inflammation or infection of the airways. This disorder is common in those who have cystic fibrosis. Bronchiectasis may be congenital or acquired later in life.
Cystic fibrosis is a genetic condition affecting mucus, sweat and digestive juices. The disorder causes these fluids to be sticky, plugging up areas of the lungs and other natural passageways.
Emphysema is a chronic, progressive condition commonly caused by smoking. Affecting approximately two million Americans, emphysema is a breakdown of the walls of the air sacs of the lung, which cause them to become abnormally enlarged. These abnormally enlarged air sacs are unable to function properly.
Pulmonary fibrosis (e.g., sarcoidosis, IPF, silicosis)
Pulmonary fibrosis is the scarring or thickening of the lungs without a known cause. This disorder generally causes difficulty in breathing or shortness of breath.
Pulmonary hypertension (both primary and secondary)
Pulmonary hypertension is a rare and serious blood vessel disorder of the lungs. It is a complex health disorder that is caused by elevated blood pressure within the lungs which can lead to heart failure. This disease affects people of all ages and ethnic backgrounds. Frequently patients with pulmonary hypertension are not recognized until they have advanced disease because early symptoms can be confused with those of many other conditions. A higher awareness, earlier diagnosis and development of a comprehensive treatment plan can improve quality of life and prognosis in this life-threatening condition.
Treatments and ServicesLung Volume Reduction for Emphysema
It is common for people who suffer from emphysema to have some portions of the lung that are more affected than others. This finding led to the development of a surgical approach to treat emphysema known as Lung volume reduction surgery (LVRS), which involves the removal of approximately 20-35 percent of the poorly functioning lung tissue from each lung. By reducing the lung size, the remaining lung and surrounding muscles are able to work more efficiently. This makes breathing easier and helps patients achieve greater quality of life.
A good candidate for LVRS is someone who has stopped smoking for at least four months and has disabling emphysema despite complete medical therapy. Patients must be able to participate in a pulmonary rehabilitation program prior to and after surgery. Any other medical conditions that the candidate may have must be well controlled and must not present unacceptable risks for complications from the procedure. Most importantly, the patient must have a pattern of emphysema that is amenable to surgical management. This means that there are poorly functioning areas of the lung that can be removed to improve lung function.
- Relief of shortness of breath
- Improved lung function
- Increased energy level and physical mobility
- Improved ability to function at normal daily activities
- May decrease need for supplemental oxygen
- Anyone who meets the general criteria can be considered for a formal evaluation. This would involve a thorough review of the patient’s medical history, physical exam, pulmonary function studies and imaging studies. These imaging studies can be done with your referring medical doctor or at Keck Hospital of USC.