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For lung transplant, researchers surprised to learn bigger appears to be better
Date:7/31/2013

Transplant teams have long tried to match the size of donor lungs to the size of the recipient as closely as possible, concerned that lungs of the wrong size could lead to poor lung function and poor outcomes. But new Johns Hopkins-led research suggests that oversized donor lungs may instead be the best option for patients, finding they are associated with a 30 percent increased chance of survival one year after the operation.

The issue of lung size was brought into the spotlight recently with the case of a 10-year-old Pennsylvania girl in need of a lung transplant. Regulations have made children under the age of 12 ineligible to receive adult lungs, primarily because of the potential size mismatch. Her situation sparked a national debate on organ allocation procedures, and her family successfully petitioned the courts to enable her to receive lungs from an adult.

"Despite what we thought, bigger lungs turn out to be better," says Christian A. Merlo, M.D., M.P.H., a lung transplant expert at the Johns Hopkins University School of Medicine and senior author of a study published in the August issue of the The Annals of Thoracic Surgery. "The survival rates for lung transplant, unfortunately, are not as good as with other solid organ transplants like liver, kidney and heart. But our study tells us that if we were to routinely transplant larger lungs into patients, we could potentially make a real impact on survival. And that's the goal of research."

Lung size can be estimated from the height and sex of the patients and is termed the "predicted total lung capacity." Taller people have bigger lungs and a man's lungs are larger than a woman's of the same height. The researchers defined lung size mismatch as the ratio of the predicted lung capacity of the donor relative to the recipient. For example, a ratio of 1.0 is a perfect size match, whereas a ratio of 1.3 indicates that the transplanted lung is significantly larger than the pred
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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