The summit participants sought advice from OPOs with higher lung procurement rates. They looked at their own procedures to see what could be improved. Whelan added ideas he had gathered while developing a donor-management protocol at the University of Washington before coming to Minnesota in 2003.
"We begged and borrowed, but a lot we created on our own," says Herrington, who was an invited expert with the breakthrough collaborative and key in instigating the lung summit. "We completely revamped the lung protocol." And it worked.
In 2005, 75 lungs were transplanted from 181 LifeSource donors—more than double the rate of the previous year. Soon the Minnesota group was fielding calls from other OPOs hoping to copy its success.
The lung summit group continues to meet every few months to review recent cases and plan further actions to improve lung procurement. "We're always looking at new opportunities and at how can we advance," Herrington says.
"It's been great," adds Whelan. "It's amazing what you can do when you work together."
The bigger picture
Thanks to these impressive improvements in organ allocation and procurement,the number of lung transplant surgeries at the University's medical center is growing. Both 2005 and 2006 were record years, with 45 and 47 transplants, respectively, compared with 19 in 2004.
"We've had outstanding results," Hertz says. "This year our numbers looked fantastic."
Ironically, those increases create new challenges for the mainstream health-care community, as individuals with once-fatal diseases prepare for transplant,then enter a new chapter in their lives with a new lung.
"All of the transplant procedures have their specific complications," Lake says. "For the physicians who see these patients, it means acquiring a whole new knowledge set they probably didn't hear about during medical school or even during residency training.
With the combined resources of the Center for Lung Science and Health and the Transplant Center—and even a dedicated transplant pharmacy—the University is well equipped to give lung transplant patients the specialized care they need before a transplant and in the days immediately following surgery.
To help cover care before and beyond transplant, Hertz and colleagues have written a book for primary care physicians on the special health-care needs of people who will or have received a lung transplant. The book, Manual of Lung Transplant Medical Care, provides valuable advice ranging from referral criteria to issues related to immunosuppression, infection prevention, and changes in the digestive, nervous, and other systems after a lung transplant.
Here at the University, lung transplant recipients and recipients-to-be have access to yet another valuable resource—each other. A hospital-sponsored support group brings patients together on Monday mornings so they can serve as a source of encouragement, information, and assistance to one another.
"The support group is critical for people who find out they need a transplant or are being evaluated for one," says Broberg, who continues to attend meetings to encourage others awaiting a transplant. "At my first meeting, one group member related that he was able to play golf 50-plus times the first summer post-transplant. He said he played somewhere around 100 rounds the following year. He looked and sounded great. I wanted some of that for myself! Right then and there, my spirits were lifted by seeing firsthand the potential for a better life through lung transplantation.
Broberg's life is not as simple as it once was. Immunosuppression turns minor inconveniences like the common cold into formidable foes. And his lung function is less than 100 percent. But, he says, it sure beats not being able to breathe at all.
"Coming down with this condition was not a lucky thing by any means. It's nothing you'd wish on anybody. But a lot of factors have gone my way since the time I found out I was ill," he says. "I tell people we are very, very blessed to have a facility like the University of Minnesota hospital right here in our backyard."
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