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'It's a whole new day for lung transplantation'
New nationwide system has saved lives of patients who are in sudden desperate need
By DENISE GRADY
New York Times
A quiet revolution in the world of lung transplants is saving the lives of people who, just two years ago, may have died on the waiting list. In the past 16 months, waits have shortened, lists have shrunk, and the number of lung transplants has gone up. Further improvements are expected this year.
"It's almost as if it's a whole new day for lung transplantation," said Dr. Cynthia Herrington, a surgeon at the University of Minnesota Medical Center, Fairview, in Minneapolis. "It's amazing."
Transplants are given to people whose lungs fail because of emphysema, cystic fibrosis or other less common diseases. Since demand exceeds supply, patients must join regional waiting lists that are part of a national network.
Recent changes have revitalized lung transplantation. Starting in May 2005, new rules nationwide put patients who needed transplants most at the top of the list — people who would soon die without a transplant but who had a good chance of surviving after one.
Previously, lungs went to whomever had been waiting longest, even if another patient had a more acute need. The waiting time was often two years or more, so there was little hope for people with lung diseases that came on suddenly or progressed rapidly.
Another major change is that more lungs from cadavers have become available, for two reasons: More people are becoming organ donors, and doctors have figured out ways to salvage lungs that previously would have been considered unusable.
The number of lung transplants has risen to 1,405 in 2005, 248 more than the year before. Fewer people are dying on the waiting list: 360 in 2005, down from 488 in 2004.
Changes in the system came about partly because of a 1998 federal regulation requiring that all organ transplants go to patients with the greatest medical need. The intention was to even out waiting times across the country and decrease deaths on the waiting list.
The new rules made the difference between life and death for Hannah Olson, 20, a college student from Waukon, Iowa, with cystic fibrosis, a genetic disease that affects the lungs and digestive system. Olson was well enough to start college in 2004, but by January 2006, she was on the transplant list.
In mid-February her lungs gave out. Olson was put on a respirator, and her waiting-list status changed to active. Without a transplant, she probably would have died within days. Her desperate condition shot her to the top of the list. Twelve hours later, lungs became available.
"I'd probably be gone if the list was the way it was before," Olson said
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