ATLANTA -- For patients who have been precluded from receiving a lung transplant because of their underlying coronary artery disease, Duke University Medical Center researchers have shown that they can achieve similar positive outcomes by performing revascularization procedures such as coronary bypass operations immediately prior to the transplant surgery.
Additionally, performing the revascularization procedures does not add additional time to the transplant procedure itself, they report. The surgeons performed the heart surgery while the patient was being prepared to receive the donor organ, which was en route to the hospital.
The researchers emphasize that this strategy is used for lung transplant patients who -- except for their heart disease -- do not have any other health problems or conditions that would preclude them from getting the transplant. They must have coronary artery disease that is amenable to a revascularization procedure, and their hearts must pump at least at 50 percent capacity.
"Typically, these patients have been turned down at most centers from having a lung transplant because of their coronary artery disease," said Vijay Patel, M.D., heart and lung transplant fellow at Duke. "Patient selection is critical; if the only medical reasons for a patient not to receive a lung transplant is the heart disease, they could be candidates for the combined procedure."
Patel prepared the results of the Duke study for presentation today (May 20) during the 98th annual international conference of the American Thoracic Society.
The researchers analyzed the clinical records of the first 350 lung transplants performed at Duke and found that 18 patients had severe coronary artery disease and received either bypass surgery (12) or an angioplasty procedure (6) prior to transplant. The survival rate for these patients was 88 percent, compared to an 81 percent survival for all other transplant patients.