Lung disease

You can call (352) 265-8940 to make a referral the to lung transplant program at the Shands Transplant Center at the University of Florida. Many lung diseases, pose special challenges with respect to lung transplantation. Patients should be younger than 65 years old for consideration for single lung transplantation (SLT), younger than 60 years old for consideration for bilateral lung transplant (BLT) operation and younger than 55 years old for consideration for heart-lung transplantation (HLT).

Cystic Fibrosis
This is the most common cause of inherited lung disease in the Caucasian population. Ninety-five percent of this population dies of progressive respiratory failure. The majority of these patients will ultimately require lung transplantation by the age of 30. Cystic Fibrosis (CF) does not recur in the transplanted lung.

The Shands at the University of Florida lung transplant program transplanted 14 patients to date. These patients range in age from 14 to 43 years old. BLT is the procedure of choice for those suffering from CF.

Chronic obstructive pulmonary diseases
Approximately 100,000 Americans die from emphysema every year. This is the most common indication for lung transplant in the country.

Patients should be referred for lung transplant evaluation when they have failed medical therapy and when their forced expiratory volume (FEV-1) is less than 25 percent of the predicted value.

Alpha-1 antitrypsin deficiency (AIAD) is the inherited form of chronic obstructive pulmonary diseases (COPD) and accounts for one percent of all patients afflicted with COPD.

The Shands at UF team transplanted 49 patients with COPD. Of those 49 patients, 16 had AIAD. SLT is the procedure of choice for the majority of these patients. A small subset with severe bilateral bullous disease will require BLT.

Interstitial Lung Disease
The majority of these patients fails medical therapy. In general, they should be referred for lung transplant evaluation when they require oxygen or when their forced vital capacity is less than 60 percent of the predicted value.

The Shands at UF team transplanted 21 patients with Interstitial Lung Disease. SLT is the procedure of choice.

Primary Pulmonary Hypertension
All symptomatic patients with Primary Pulmonary Hypertension (PPH) should be on continuous intravenous Prostacyclin (FLOLANTM). All of our symptomatic patients are treated with FLOLAN as a standard of medical care. Patients should be followed closely while on FLOLAN and should be listed for lung transplantation at the earliest signs of progression while on therapy. BLT is the preferred procedure of choice.

Eisenmenger's Syndrome
Patients should be referred for transplant evaluation when they experience a poor quality of life (unable to do activities of daily living). The timing of transplantation depends on progression of their symptoms.

The Shands at UF team transplanted four patients with Eisenmenger's syndrome. BLT with repair of the congenital heart disease is preferred whenever repair is possible. Otherwise, HLT is the procedure of choice.

Bronchoalneolar Carcinoma
Worldwide, only six patients have undergone transplantation. We will consider patients for transplantation if they have disease localized to their lungs without involvement of their mediastinal lymph nodes and have failed primary therapy. BLT is the procedure of choice.

Chronic rejection
Fifty percent of lung transplant recipients have chronic rejection five years after their lung transplant. These patients should be considered for a retransplant operation when their FEV-1 is less than 25 percent of the predicted value. SLT is the procedure of choice. The indications for lung transplantation change as technology evolves and alternate or adjunct therapies become available.

The Shands at UF team performed four retransplant operations. We now transplant many patients with conditions previously considered contraindications to transplantation. Future developments will undoubtedly change our perspective on the complicated issues discussed above.

Statistics
Success rate and various other statistics regarding the Shands Transplant Center at UF are available from the Scientific Registry of Transplant Recipients at ustransplant.org.

Information
For more information about the Shands Transplant Center Lung Transplant Program, please call (352) 265-8940.

Related Links
CHF Patients

Transplant Navigation

Heart and Lung Transplant

Lung Transplant Navigation

Diseases of the lungs

Pediatric lung transplant

Process

Recovery

Referral

Make an Appointment

To make an appointment or find out more information about transplant services offered at Shands at the University of Florida, please call 352.265.8000 or toll-free 1.800.749.7424

You may also email our Consultation Center (consult@shands.ufl.edu) or use our secure online form.