An increasing number of complex lung transplant cases in Ohio

As the only medical center in Central Ohio to provide lung transplants in central Ohio, the comprehensive transplant center at Wexner Medical Center at Ohio State University manages an increasingly complex cohort of cases.

“Since the center's first lung transplant in 2013, we have continued to intensify treatment and added the advanced techniques needed to help people with more challenging diagnoses,” says Justin Rosenheck, Do, an assistant professor of lung disease and clinical medicine in the internal medicine department of Ohio State University School of Medicine. “This improvement in care has resulted in an increase of over 60 from January to November 2024 after 55 lung transplants were completed in 2023. But even more importantly, our results consistently meet national standards, even when they are increasingly complex, with added volume.”

One of the capabilities Dr. Rosenheck highlights is Ohio's status as one of the few locations across the state that provides extracorporeal membrane oxygenation (ECMO) in adults to patients with endostage lung disease.

“When it comes to transplants, it can take time to find a match. Ecmo has given us the ability to stabilize patients with the most acute illnesses and optimize for successful transplant,” he says. “There's also patient pulmonary perfusion, or EVLP. This allows for more donor lung repair and resuscitation. Both techniques have changed the numbers positively.”

We investigated the use of researchers in Ohio Electrical impedance for non-invasive measurements of lung quality Assessed by tissue edema in an animal model of normothermal EVLP.

Ohio has successfully performed re-transplants of multiple lung recipients, one of the nation's first centers to perform Covid-19-related double lung transplants, investing in an organ recovery team along with eight organ recovery experts and a surgeon who works to manage all the logistics of organ assessment, recovery and transport from across the country. Every day, the team reviews 15-20 organs, including lung offers.

Benefits of multidisciplinary care

“Even patients who do not need the use of advanced technologies such as ECMO or EVLP face unique challenges,” says Dr. Rosenheck. “Our goal is to identify and mitigate these risks before a person receives a call that their donor has been discovered.”

Some members of the human care team have special experiences in respiratory surgeons, surgeons, post-transplant and post-post coordinators, social workers, transplant psychologists, financial coordinators, respiratory therapists, dietitians, physical therapists, dietitians, physical therapists, all pharmacists and paralysis medicine.

To further improve results, pre-transplant testing includes screening for vaccination status, overall health and physical condition, cardiac assessment, bone density tests, dental clearance, and testing of stomach and esophageal function. Target Care will continue post-transplant continuation with a dedicated team of internal medicine hospitalists who work with post-transplant hospital medicine to provide specialized care to those who are readmitted to the hospital at any time after transplant.

“All technologies in the world cannot replace personalized care or help people with the many lifestyle and health factors that affect outcomes,” says MD Bronwyn Small. “Our interdisciplinary approach allows Ohio to accept more medically complex patients. Most lung transplant programs accept only every 10 people referred. About one in six people can be implanted.”

As an example of a focused specialization of the program, she cites Ohio's expertise in identifying and managing progressive interstitial lung diseases and other acute lung diseases.

“We've been particularly wary and learned how to quickly diagnose these types of conditions and effectively transition care to the transplant team to save more lives, as it can be difficult to even identify them.”

Breakthrough Investigation

Ohio Comprehensive Transplant Center Action Basics, translation, clinical research. This includes several industry-sponsored studies on research drugs to prevent allograft rejection, a major cause of transplant disorders, and advanced rehabilitation studies to assess the benefits of ongoing respiratory therapy before and after implantation.

Dedicated transplant labs include both the Bumgardner Institute and Schenk Laboratory, which investigate transplant immunobiology. Copper Research Institute (Collaboration for organ perfusion, protection, engineering, and regeneration).

Research partnerships take place at Ohio State University's inter-departmental and at other healthcare centers. Recent publications include:

“We are always looking for opportunities to work with other centres, and we recommend contacting interested researchers. Department of Lung, Critical Care and Sleep Medicine Or refer the patient to us Clinical trialsDr. Rosenheck says.

The department's research program includes lung transplants and the following:

• Airway and Environmental Lung Diseases
• Severe diseases – Acute dyspnea syndrome and sepsis
• Interstitial lung disease
• Lung aging
• Pulmonary vascular biology and diseases
• Sleep Medicine Research Program

“Our department also encourages learners to research opportunities,” says Dr. Small. “Undergraduate and graduate students, postdoc students and clinical peers can participate in local, national and international conferences and workshops, providing ongoing mentorship to support those interested in developing research skills.”

Ohio also provides NIH funding Postdoctoral Research Training Fellowship in the Biology of T32 Aging and Lung Diseases There is three years of structured training for post-doctor fellows from MD or PhD backgrounds.

Learn more about care and research innovations in the departments of Lung, Critical Care and Sleep Medicine.