The Washington University-Barnes Hospital experience with lung transplantation

Article Abstract:

The earliest lung transplants were not successful, with few patients surviving more than a month. However, in the 1980s many technical problems were overcome, and lung transplants became more common and more successful. For many patients, such as those with advanced cystic fibrosis (an inherited disorder that causes mucous to build up in the lungs), chronic obstructive lung disease (diminished lung capacity from chronic bronchitis, asthma or emphysema, made worse by smoking or pollution) and emphysema (a disorder causing overinflation of the lungs, loss of lung elasticity, and other changes), there is no alternative if they are to survive at all. Sixty-nine lung transplantations at Washington University-Barnes Hospital in St. Louis were reviewed to determine the success of recipient selection, type of procedure, lung function, and overall outcome of transplants performed between July 1988 and January 1991. Patients up to the age 60 were considered. Those who were undergoing prior systemic steroid therapy tended to do worse than other patients. Previous heart or chest surgery also increased the likelihood of a poor outcome. Surgical procedures have not changed significantly since the first operations, but a broader range of patients is being treated, and greater success has been achieved with single lung transplants in patients with obstructive lung disease and emphysema. During the study period, 66 transplants were performed on 69 patients. Long-term survival after single lung transplant was 90 percent; after bilateral transplant it was 82 percent. The longest-term survivor was approaching 16 months after surgery. Although problems remain, lung transplantation is now a reasonable choice for carefully screened patients with end-stage lung disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Lungs, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Lung transplantation, Washington, University of. School of Medicine

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Recent developments in the treatment of lung cancer

Article Abstract:

Lung cancer is the second most common cancer in the US population. Five-year survival rates for individuals diagnosed with lung cancer have only improved from 12% in 1974 to 13% in 1987. Most cases of lung cancer can be classified as either non-small cell lung cancer (NSCLC), or small cell lung cancer (SCLC). Patients with SCLC are more likely to have cancer that has spread throughout the body than patients with NSCLC. Patients with NSCLC may undergo surgery, or they may receive radiation therapy or chemotherapy. Survival rates for NSCLC patients vary depending on the extent of disease upon diagnosis. Patients with small cell lung cancer (SCLC) are divided into those with a localized tumor, or those with cancer that has spread to other parts of the body. The majority of SCLC patients are treated with chemotherapy using combinations of different drugs. Combination chemotherapy has improved survival rates for SCLC patients, but only 5% survive 10 years or longer after diagnosis. Many cases of lung cancer could be prevented by discouraging individuals from smoking.

Care and treatment, Lung cancer

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Research Opportunities and Advances in Lung Disease

Article Abstract:

Future treatments for lung disease will include gene therapy, stem cell transplants, and monoclonal antibodies. Vaccines can be tailored to stimulate immunity to specific microorganisms that infect the lungs and new treatments should be available for asthma, chronic obstructive pulmonary disease, and interstitial lung disease.

Lung diseases

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