Adult Lung Transplant Services
Dedicated to the Care of Patients with Pulmonary Disease
The Lung Transplant Program at University Hospital was established in 1987 by a pioneer in Lung Transplantation, Dr. John Kent Trinkle. University Health System in partnership with The University of Texas Health Science Center at San Antonio have been leaders in the care of people with end stage lung disease. Every patient referred to the Lung Transplant program benefits from our strong history of research, education, creative innovation, comprehensive medical expertise and surgical excellence. Our survival statistics meet the national average and we have transplanted some of the longest surviving lung transplant patients in the nation.
Pioneering Force in Lung Transplantation
- In 1987 we performed the first lung transplant in North America for the treatment of emphysema.
- In 1987 we performed the first heart/double lung transplant in San Antonio.
- In 1989 we performed one of the first single lung transplants in the World for pulmonary hypertension.
- Dr. J. Kent Trinkle developed a surgical method in lung transplant called "telescoping". This was developed to decrease the problems of rupture and narrowing of bronchial suture sites.
Diagnoses
A lung transplant may be needed for the following diseases:
Interstitial Lung Diseases
Idiopathic Pulmonary Fibrosis (IPF)
Sarcoidosis
Hypersensitivity Pneumonitis
Pulmonary Manifestations of Collagen Vascular Disease
Eosinophilic Granuloma
Lymphangiomyomatosis (LAM)
Pulmonary Vascular Disorders
Primary Pulmonary Hypertension (PPH)
Obstructive Lung Diseases
Chronic Obstructive Pulmonary Disease (COPD)/Emphysema
Alpha 1 Antitrypsin Deficiency
Cystic Fibrosis
Bronchiectasis
Evaluation Process
Patients must be evaluated to determine their candidacy for transplantation. An initial visit will be scheduled with our transplant pulmonologist, surgeon and coordinator. This visit will determine if the patient should proceed with the transplant evaluation. If performed at our facility the evaluation will take up to 4 days.
The evaluation consists of:
- Bloodwork
- Urine tests
- Radiologic tests
- Heart and Lung tests
- Tests for osteoporosis
- Dental consult
- Interview with a social worker
- Gastrointestinal consult for patients with scleroderma or a history of reflux
- Females: pap smear and mammogram
Our diverse and specialized transplant team
Cardiothoracic Surgeons and Pulmonologists specializing in lung transplantation
Nurse Transplant Coordinators
Financial counselors
Clinical nurse specialist for transplant
Discharge planner
Transplant social workers
Transplant dietician
In-patient rehabilitation facility
Lung Transplant Candidate Selection
- Patients with advanced lung disease: Failed all possible medical therapies available to them.
- High risk of death in two or three years
- Functionally disabled but still able to ambulate
- Patient does not exceed the maximum age for transplant:
- Maximum age of 60 years for a bilateral lung transplant
- Maximum age of 65 years for a single lung transplant
Transplant Surgery
Most Transplant Patients...
- Are in surgery approximately 3-7 hours
- Spend 1 day on the breathing machine
- Spend 1-2 days in the intensive care unit
- Are discharged 7-12 days after their surgery
Hospital Stay
The J. Kent Trinkle Transplant unit creates an atmosphere dedicated to the compassionate care of the patient and family:
- State of the art facilities
- Cutting edge technology
- All private rooms
- Physicians in hospital 24 hours a day
Follow up Care
After transplant, patients are followed closely in our clinic. The first 3 months we require weekly visits to our clinic. During this period blood levels are drawn to adjust medications as necessary; chest x-rays and pulmonary functions tests are performed to assess the condition of the lungs. After the first 3 months the appointments will be scheduled further apart depending on the progress of the patient. Once the patient is stable we start sharing responsibility with the referring pulmonologist for patient care. We strongly encourage the referring doctor to contact us with any questions or problems.
Reasons not to transplant
- Advanced heart, kidney or liver disease
- HIV infection
- Cancer
- Hepatitis B
- Hepatits C with proven cirrhosis by liver biopsy
- Current substance abuse: tobacco, alcohol and illicit drugs
- Body weight less than 80% or greater than 120% of predicted
Other Areas of Expertise
- Pulmonary hypertension
- Lung cancer
- Tracheal stenosis
- Complicated pleural effusions
- Tracheomalasia
Interventional Pulmonology
- Rigid bronchoscopy
- Stent placement
- Laser, Cryotherapy, Electrocoagulation
- Medical thoracoscopy under conscious sedation
- Percutaneous tracheostomy
