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

icted total lung capacity for the recipient. Merlo's research found that double lung transplant recipients who received lungs with an average ratio of 1.3 were 30 percent less likely to die in the first year.

The research, led by Michael Eberlein, M.D., Ph.D., a former Johns Hopkins medical resident and fellow, was done by analyzing data from 4,520 double lung transplants and 2,477 single lung transplants performed between May 2005 and April 2010 in the United States. The findings were clearer about the benefits of larger lungs in double lung transplants than in single ones, though oversized lungs did convey some survival benefit in those cases as well, they found.

"Size is a more powerful predictor of survival than we ever thought," says Ashish S. Shah, M.D., surgical director of lung transplantation at The Johns Hopkins Hospital and another of the study's authors. "Fears of oversized lungs appear to be unfounded. We hope this research dispels some myths."

In lung transplant, the sickest patients move to the top of the list. Once an adult patient is atop the list, height and gender (along with blood type) are used to determine whether those lungs are suitable for that patient. Merlo and Shah say it might be better to build in a calculation for predicted lung capacity. That way, oversized lungs could be offered to patients instead of smaller lungs that may not work as well.

Lungs can be too large, they caution. If lungs are beyond a certain size, surgeons could have trouble closing the chest cavity, the lungs could be too compressed and collapse or could weigh too heavily on the heart, causing low blood pressure and other problems.

Currently, children under 12 cannot receive adult lungs and adults cannot receive lungs from pediatric donors. Shah, an associate professor of surgery at Johns Hopkins, says the findings suggest that there may be some benefit to removing age from the equation altogether when allocating lungs, p
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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