Programs that teach lung, bowel transplantation

[sean wilson]

---

Members don't see this ad.

I understand that lung is one of the most demanding types of transplant. There are many places that transplant hearts, but few that do lungs, which are often done in conjunction with one another. Small bowel is essentially experimental at this stage, and just a few places, Mount Sinai being one of them, does these.

Can anyone tell me why lung and/or bowel transplantations are so difficult to do?

 

[Docxter]

Actually lung transplants are not all that uncommon. Small bowel transplants are uncommon. The reason for few SB transplants is poor viability of the transplant and rejection and related problems of immunosuppression. There were 116 small bowel transplants done at 15 centers in 2003 in the US. Almost half were done in the transplant capital of the world, Pittsburgh. The other two centers which do a substantial number are Jackson Memorial in Miami and University of Nebraska. These centers do about 75% of all SB transplants in the country.

Lung transplants are not that rare on the other hand. 1085 lung transplants (excluding Heart\Lung transplants) were done at 67 centers in 2003 with 18 centers doing more than 25.

 

[sean wilson]

Interesting stuff. Can you comment on the relative difficulty difference between lung and heart transplants? I've seen many places that do the latter, but it seems to me, at least, lungs are not as common. During the interview period, a PD mentioned their being more difficult, but didn't get into why this would be.

Thanks,

SW

 

[Tenesma]

small bowel/pancreas transplants - relatively uncommon and the anesthesia in of itself is not all that complicated - the post-op ICU care is a handful sometimes.

lung transplants i believe are far more difficult from an anesthetic point of view compared to hearts... I remember being in awe of heart transplants when i first started doing them, and now they aren't all that impressive (unless of course you are implanting the heart into somebody who has somewhat difficult pulmonary hypertension (which in of itself is a relative contra-indication) - and you end up with Nitric Oxide ventilation/IV Viagra/IV prostaglandins, etc...) I find double lungs (single lungs are just big thoracic cases) to be a lot more difficult in general.

 

[Whisker Barrel Cortex]

At University of Wisconsin, there are many heart transplants and lung tranplants. Renal and liver are also extremely common. Small bowel / cluster tranplants are rare, but they do them here. From what I have seen, the results of these are often not favorable and most of the kids that have this done are in the hospital very frequently.

 

[sean wilson]

Thanks!