Breaking New Life into VCU Health's Lung Transplant Program

By Holly Prestidge

After nearly 20 years of rest, VCU Health's lung transplant program is back.

In late September, the words came that applications for the health system were accepted to resume the program. For MD Vipul Patel, planning for the past nine months – securing an interdisciplinary team that includes everyone from surgeons to nutritionists and identifying potential transplant candidates has led to this new reality.

Lung transplants are expected to begin early 2025, in which case VCU health will only be Virginia's third health system.

Vipul Patel, MD, medical director of lung transplants at VCU Health Hume-Lee Transplant Center, was hired in 2024 (MCV Foundation, Daniel Sangjib Min)

“It's a huge achievement,” said Patel, a doctor hired in March 2024 to lead the program. “We're active again.”

Achievement did not occur in a vacuum.

actual, Partition of lung diseases and critical care medicine In recent years, the medical school at Commonwealth University, Virginia, has changed. The strategic adoption and readjusted mission statement sharpens the focus to do more to patients by diving and expanding Virginia into care in subspecialties of lung specialties, such as asthma, a national hotspot.

Establishing a lung transplant program is not easy. Ultimately, there is a need for a subspecialty program to support lung transplantation, which requires very thoughtful and intentional planning.

PATRICK NANA-SINKAM, MD, Director of Lung Disease and Critical Care Medicine, VCU School of Medicine

Cystic fibrosis and pulmonary hypertension are other areas of disease and, like chronic obstructive pulmonary disease, are well known as COPD.

Sarcoidosis, an inflammatory disease that can affect multiple regions of the body, is yet another disease with a higher prevalence in Virginia and the southeastern United States

Each of these lung care areas is meticulously addressed at VCU Health through carefully selected professional faculty, active research pursuits, and highly selective educational programs that train the next generation of pulmonary health professionals. Collectively, these subspecialties represent the foundation on which VCU health is building successful mass transplant programs.

“We are an interdisciplinary, multispecialized, comprehensive care center,” said Dr. Patrick Nana Sinkham, director of the School of Lung Disease and Critical Care Medicine.

Building from scratch

As the transplant progresses, the lungs are another animal.

Often considered more challenging than heart, liver, and kidney transplants, lung transplants pose serious risks. Immunosuppressants needed to help reduce the risk of organ rejection also weaken the immune system of recipients, which open the door to infection. These medications are taken for the rest of the patient's life.

Unlike the heart, liver and kidneys, the transplanted organ can add a patient's lifespan for many years, but lung transplants do not provide such a lifespan promise. Five-7 years is the best case scenario for most people.

Still, lung transplantation provides relief for patients with no other options.

Over 3,000 lung transplants were performed nationwide in 2023. This is a milestone for that organ, according to UNOS, the national organ sharing network where VCU Health currently has membership in lung transplants.

Under Patel, the program first performs 10-30 ports each year over a few years, then up to 50 ports each year.

This is in stark contrast to the lung transplant program that existed at VCU Health between 1991 and 2006. During that time, a total of 38 lung transplants were performed. At most, four were done in a year.

Patrick Nana-Sinkam, MD, Director of Lung Disease and Critical Care Medicine, VCU School of Medicine. (Virginia Commonwealth University)

The lung transplant program is high in volume and thrives when results are successful, and Patel came to VCU Health after working at several large-volume centers in Arizona and Maryland, and then at several large-volume centers in Arizona and Maryland, ages 80-100-30-40, respectively. He specializes in transplants that include both lungs, but he said it is barely exceptionally standard across the world.

Nana-Sinkam, adopted by VCU Health in 2016 to expand lung care, reflected those ideas. VCU Health has gained momentum over the past decade as a comprehensive lung care center, he said.

“Establishing a lung transplant program is not easy,” he said. “We need subspecialized programs to ultimately support lung transplants. Successful programs are entirely dependent on infrastructure, so we need very thoughtful and intentional planning.”

All employment is extremely important and all connections between fields must be strong, from preoperative assessments to surgical care and postoperative pulmonary rehabilitation. The VCU Health Hume-Lee Transplant Center leads the lung transplant program and works closely with the division of lung disease and critical care medicine to ensure the best possible patient care.

“The outcome, and ultimately the certification, is directly linked to the number of patients in the management and infrastructure,” says Nana-Sinkam. “If there is no interdisciplinary team working together in a seamless way, or if the lung rehabilitation facility is not capable of supporting patients before and after surgery, the transplant program is unlikely to succeed. We are fortunate to have an incredible team that worked together to make this happen for our patients.”

A unique approach to care

In the case of so-called “rare” illnesses, VCU Health sees approximately 2,500 patients with sarcoidosis per year. In fact, a heat map posted on the corridor message board near the West Hospital Office in AAMER SYED, Maryland, shows the prevalence of diseases in Virginia and nearby Southern states.

There is no crucial reason, but it has been fully impacted across Virginia as VCU Health has taken a new approach to treating it.

Sarcoidosis, an inflammatory disease, affects not only the lungs, but also the heart, kidneys, joints, eyes and other areas. It occurs when there is an inappropriate body reaction that causes persistent inflammation, which ultimately leads to organ damage, blindness, heart failure, and other serious conditions. If discovered quickly enough, the disease is easy to manage.

We do everything together. I don't think there are any other programs that have many doctors in various specialties implanted together.

Aamer Syed, MD, co-founder of VCU Health Sarcoidosis Clinic

One of the first 10 centres to be designated as a world's outstanding world center, VCU Health's Sarcoidosis Clinic looks at patients of all ages between 18 and 80 years old.

Of the patients, about 70% are African-American women, Syed said.

Sarcoidosis spans many areas of the body, and therefore the VCU Health treatment system was built around addressing patient needs simultaneously. The Sarcoidosis Clinic began 12 years ago with a team on respiratory, heart disease and rheumatology, and now includes neurology, neuroophthalmology and hepatology.

“Our clinic is very unique,” said Syed, one of the founders of the Sarcoidosis Clinic. Healthcare is often broken, he said. Many doctors are strict about their specialties.

“So patients go among experts and can become a problem when they recall patients,” he explained. “However, sarcoidosis can affect so many parts of the body at once, so all of those issues bring together visits and under one roof.”

Aamer Syed, MD, co-founder of the VCU Health Sarcoidosis Clinic, is studying patient scans. This clinic is one of the first 10 designated as the World Center of Excellence. (Daniel Sangjib Min, MCV Foundation)

During one visit, patients with sarcoidosis can see the location of the stone points in VCU Health and their cardiologist and rheumatologist Syed.

“Patients like interconnectedness,” he said. “We are the quarterbacks who manage all these organ systems and have proven to be extremely popular.”

VCU Health's program is one of the largest in the country, he said, and the group intentionally lacks a director.

“We do everything together,” he said. “I don't think there are any other programs that have many doctors in different specialties implanted together.”

Looking ahead

VCU Health will open a new lung and cardiac rehabilitation facility at Reynolds intersection in Henrico County, Virginia in 2025. The facility will provide the preoperative care needed to ensure that your lung transplant candidates are well-healthy for transplantation.

Lung rehabilitation works with approximately 300 patients a year. Currently, the service is located at VCU Medical Center in downtown Richmond.

The new facility is another feather in the VCU Health cap for lung care.

“We are committed to ultra-specialists everywhere,” says Alpha “Berry” Fowler III, MD, former chairman of the Department of Lung Disease and Critical Care Medicine and current Professor of Medicine William Taliaferro Thompson.

“Research makes us stand out,” he said. “We train future respiratory practitioners and have one of the best programs in the country.

Discover how Hume-Lee Transplant Center's multidisciplinary care can lead to patient success

This story version was originally published by the MCV Foundation