From organ preservation to surgical technique, lung transplant medicine has undergone a series of quiet revolutions — and the demands on hospitals are changing with it.
Gerard Criner, MD, director of the Temple Lung Center at Philadelphia-based Temple Health, who also is chair and professor of thoracic medicine and surgery at Temple University’s Lewis Katz School of Medicine, spoke to Becker’s about what this evolution means for health systems and the future of transplant medicine.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: From a health system perspective, what’s changed that has broad implications for hospitals today?
Dr. Gerard Criner: Select patients with advanced lung diseases may have better quality of life and survival outcomes with lung transplantation.
Q: Chronic lung diseases are on the rise and demand for transplants is increasing. What should Becker’s readers understand about the gap between supply and demand?
GC: Less donors means patients wait longer for transplant, which can contribute to increased risk of death on the wait list and less patients overall receiving the benefits of lung transplantation.
Q: What challenges remain around workforce, access and equity within the field of lung transplant?
GC: Transplant exemplifies the value of a multidisciplinary team in the management of patients with advanced lung diseases; it is only one treatment, not the only treatment, for patients with advanced lung disease, and all options should be available at any center that does lung transplantation.
Q: From your vantage point, what has been the single most game-changing breakthrough in lung transplant medicine that truly altered patient outcomes or program viability?
GC: It’s just not one, it’s several. Better management of advanced lung disease pre-transplantation, better storage options for donor lung preservation, increased donor age, the advent of donation after circulatory death and the use of ex vivo lung perfusion, selective use of single versus double lung transplantation, and minimally invasive incisions for the transplant procedure are a few.
Q: Looking ahead, do you see lung transplant as entering a “new era” where more patients will qualify and more systems will need to participate? GC: Better outcomes at specialty centers will be the centers of lung transplant care for the foreseeable future. It takes a large multidisciplinary team, not just a few individuals, to ensure optimal patient outcomes.
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